Healthcare Provider Details

I. General information

NPI: 1386931806
Provider Name (Legal Business Name): KOKILA NAGENDRAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KOKILA BINDIGANAVILE

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1633 N CAPITOL AVE
INDIANAPOLIS IN
46202-1261
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-962-0963
  • Fax: 614-293-4556
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01070751A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number01070751A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: