Provider Demographics
NPI:1659529816
Name:NAGARAJU VEERAMACHANENI, M.D.P.C
Entity Type:Organization
Organization Name:NAGARAJU VEERAMACHANENI, M.D.P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:NAGARAJU
Authorized Official - Middle Name:
Authorized Official - Last Name:VEERAMACHANENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-298-1744
Mailing Address - Street 1:5150 N 16TH ST
Mailing Address - Street 2:STE B232
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-3990
Mailing Address - Country:US
Mailing Address - Phone:623-298-1744
Mailing Address - Fax:623-298-1738
Practice Address - Street 1:13634 N 93RD AVE
Practice Address - Street 2:STE 200
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4914
Practice Address - Country:US
Practice Address - Phone:623-298-1744
Practice Address - Fax:623-298-1738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-29
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ24392207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ360909Medicaid
AZZ125946Medicare PIN