Healthcare Provider Details

I. General information

NPI: 1467696880
Provider Name (Legal Business Name): ANAND DORAI RAJU M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 N DUNLAP ST STE. G145
MEMPHIS TN
38105-4625
US

IV. Provider business mailing address

37 N ARCADIAN CIR APT 204
MEMPHIS TN
38103-5996
US

V. Phone/Fax

Practice location:
  • Phone: 901-287-5565
  • Fax:
Mailing address:
  • Phone: 901-907-8821
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085P0229X
TaxonomyPediatric Radiology Physician
License Number53710
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number53710
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: