Provider Demographics
NPI:1598887473
Name:ORUGANTI, NAGAVIJAYA (MD)
Entity Type:Individual
Prefix:
First Name:NAGAVIJAYA
Middle Name:
Last Name:ORUGANTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5505 EDMONDSON PIKE STE 202
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-5869
Mailing Address - Country:US
Mailing Address - Phone:615-236-9144
Mailing Address - Fax:629-216-1209
Practice Address - Street 1:5505 EDMONDSON PIKE STE 202
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-5869
Practice Address - Country:US
Practice Address - Phone:615-236-9144
Practice Address - Fax:629-216-1209
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43129207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3001042Medicare PIN