Mallela, Rajesh
Mallela, Rajesh is an individual health care provider with primary practice located at 208 Corwin Ln , Kokomo IN 46902-6612. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Mallela, Rajesh can be contacted via phone (765) 864-8700.Contact Information
Primary practice address
208 Corwin Ln
Kokomo IN 46902-6612
Phone: (765) 864-8700
Fax: (765) 864-8715
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 01055567A | Indiana |
Profile Details
| NPI number | 1487622304 |
|---|---|
| LBN Legal business name | Mallela, Rajesh |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 8th, 2006 |
| Last updated | Feb 11th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487622304 | NPPES |
| Indiana | MEDICAID | 200388170 | |
| Indiana | Other | P01824494 | |
| Indiana | MEDICAID | 200388170A |
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