Provider Demographics
NPI:1477086189
Name:JONNA, YOGESH (MD)
Entity type:Individual
Prefix:
First Name:YOGESH
Middle Name:
Last Name:JONNA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8558 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7032
Mailing Address - Country:US
Mailing Address - Phone:219-392-7084
Mailing Address - Fax:219-703-6854
Practice Address - Street 1:9104 COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2907
Practice Address - Country:US
Practice Address - Phone:219-836-4473
Practice Address - Fax:219-703-6657
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2024-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01093666A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300042706Medicaid
IN1104231355OtherANTHEM