Provider Demographics
NPI:1639758139
Name:RAJENDRAN, NEVETHA (MD)
Entity type:Individual
Prefix:
First Name:NEVETHA
Middle Name:
Last Name:RAJENDRAN
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 1:1813 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1920
Mailing Address - Country:US
Mailing Address - Phone:205-934-4793
Mailing Address - Fax:
Practice Address - Street 1:1825 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-2632
Practice Address - Country:US
Practice Address - Phone:205-934-4793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-03
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program