Provider Demographics
NPI:1578510087
Name:NAGARAJ, HOSAKOTE (MD)
Entity Type:Individual
Prefix:
First Name:HOSAKOTE
Middle Name:
Last Name:NAGARAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 1ST ST N
Mailing Address - Street 2:STE 500
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-8740
Mailing Address - Country:US
Mailing Address - Phone:402-328-4922
Mailing Address - Fax:
Practice Address - Street 1:1022 1ST ST N
Practice Address - Street 2:STE 500
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007
Practice Address - Country:US
Practice Address - Phone:402-328-4922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-28
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27653207RC0000X
NE26836207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026072300Medicaid
NE10026072600Medicaid
NE10026072400Medicaid
NE10026072000Medicaid
NE10026072200Medicaid
NE10026072500Medicaid
NE10026072400Medicaid