Provider Demographics
NPI:1942253992
Name:NATARAJAN, MONIKA (MD)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7645 WOLF RIVER CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1751
Mailing Address - Country:US
Mailing Address - Phone:901-405-0275
Mailing Address - Fax:901-869-2908
Practice Address - Street 1:7645 WOLF RIVER CIR STE 100
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1751
Practice Address - Country:US
Practice Address - Phone:901-405-0275
Practice Address - Fax:901-869-2908
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3867904Medicaid
7254795OtherCIGNA
32093OtherTLC
TN4052154OtherBCBS OF TENNESSEE
7608293OtherAETNA
470882104OtherTRICARE
H47737OtherHEALTHSPRINGS
470882104OtherUNITED HEALTHCARE
3867904Medicare PIN
32093OtherTLC
7608293OtherAETNA
TN3867904Medicaid