Provider Demographics
NPI:1801943857
Name:PADMALINGAM, RAJESWARY (MD)
Entity type:Individual
Prefix:
First Name:RAJESWARY
Middle Name:
Last Name:PADMALINGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAJ
Other - Middle Name:
Other - Last Name:PADMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6920 POINTE INVERNESS WAY, SUITE 200
Mailing Address - Street 2:MEDPARTNERS, ATTN: BARB COPELAND
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-7934
Mailing Address - Country:US
Mailing Address - Phone:260-479-3514
Mailing Address - Fax:260-479-3520
Practice Address - Street 1:7950 W JEFFERSON BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-4140
Practice Address - Country:US
Practice Address - Phone:260-435-7123
Practice Address - Fax:260-435-7234
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01075718A2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201323180Medicaid
F04360Medicare UPIN
IN201323180Medicaid