Provider Demographics
NPI:1831207323
Name:INDUKURI, RAJU V (MD)
Entity type:Individual
Prefix:DR
First Name:RAJU
Middle Name:V
Last Name:INDUKURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 FELECIA ST
Mailing Address - Street 2:SUIT 103
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4023
Mailing Address - Country:US
Mailing Address - Phone:615-649-0676
Mailing Address - Fax:615-649-0671
Practice Address - Street 1:2900 FELECIA ST
Practice Address - Street 2:SUIT 103
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4023
Practice Address - Country:US
Practice Address - Phone:615-649-0676
Practice Address - Fax:615-649-0671
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD281382084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
3080683OtherBCBS
TN3819924Medicaid
TN3819924Medicaid
G68208Medicare UPIN