Provider Demographics
NPI:1386931806
Name:NAGENDRAN, KOKILA (MD)
Entity type:Individual
Prefix:
First Name:KOKILA
Middle Name:
Last Name:NAGENDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KOKILA
Other - Middle Name:
Other - Last Name:BINDIGANAVILE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1633 N CAPITOL AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-1261
Practice Address - Country:US
Practice Address - Phone:317-962-0963
Practice Address - Fax:614-293-4556
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01070751A207R00000X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201066510Medicaid
INP01141375Medicare PIN
INM400070659Medicare PIN