Mysore Rangaraju, Ayyappa

Mysore Rangaraju, Ayyappa is an sole proprietor health care provider with primary practice located at 2421 W 21St St Ste B , Clovis NM 88101-2006. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Mysore Rangaraju, Ayyappa can be contacted via phone (575) 769-7577.

Contact Information

Primary practice address
2421 W 21St St Ste B Clovis NM 88101-2006
Phone: (575) 769-7577
Fax: (575) 742-7856
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD2017-0029 New Mexico
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD2017-0029 New Mexico

Profile Details

NPI number 1093059925
LBN Legal business name Mysore Rangaraju, Ayyappa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2012
Last updated Oct 2nd, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093059925 NPPES
New Mexico MEDICAID 34803548

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