MEDICARE: THIRUMALAIRAJ JEEVAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	D45707	MD
2	207RP1001X	Pulmonary Disease Physician	D45707	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CE8614 290010022	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	KA95MA 54586701	OTHER	MD	CAREFIRST
3	3340 0003	OTHER	DC	CAREFIRST
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306827936
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THIRUMALAIRAJ JEEVAN M.D.

Provider Business Mailing Address
First Line	:	10845 PHILADELPHIA RD
Second Line	:
City	:	WHITE MARSH
State	:	MD
Zip	:	21162-1717
Country	:	US
Telephone Number	:	410-335-0008
Fax Number	:	410-335-1133

Provider Business Practice Location Address
First Line	:	1600 CRAIN HWY S
Second Line	:	SUITE 308
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5577
Country	:	US
Telephone Number	:	410-760-5510
Fax Number	:	410-760-5925

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	05/30/2008

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