Provider Demographics
NPI:1821348863
Name:THURAIRAJAH, PREM H (MD)
Entity Type:Individual
Prefix:
First Name:PREM
Middle Name:H
Last Name:THURAIRAJAH
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 1:800 ROSE ST, MN649
Mailing Address - Street 2:UNIVERSITY OF KENTUCKY, DIVISION OF
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0298
Mailing Address - Country:US
Mailing Address - Phone:859-323-4887
Mailing Address - Fax:859-257-8860
Practice Address - Street 1:800 ROSE ST, MN649
Practice Address - Street 2:UNIVERSITY OF KENTUCKY, DIVISION OF
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0298
Practice Address - Country:US
Practice Address - Phone:859-323-4887
Practice Address - Fax:859-257-8860
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-18
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYFL038207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology