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1316644180 NPI number — SHIVANAND AVIN MAHARAJ M.D.

NPI Number: 1316644180
Health Care Provider/Practitioner: SHIVANAND AVIN MAHARAJ M.D.

Information about “1316644180” NPI (SHIVANAND AVIN MAHARAJ M.D.) exists in 1316644180 in HTML format HTML  |  1316644180 in plain Text format TXT  |  1316644180 in PDF (Portable Document Format) PDF  |  1316644180 in an XML format XML  formats.

NPI Number : 1316644180 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316644180",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MAHARAJ",
    "FirstName": "SHIVANAND",
    "MiddleName": "AVIN",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1211 UNION AVE STE 330",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MEMPHIS",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "38104-6655",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1325 EASTMORELAND AVE STE 260",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MEMPHIS",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "38104-7549",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "901-272-6051",
    "PracticeLocationAddressFaxNumber": "901-266-6443",
    "EnumerationDate": "02/13/2023",
    "LastUpdateDate": "07/17/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": "09/19/2023",
    "NPIReactivationDate": "12/19/2024",
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Y00000X",
        "TaxonomyName": "Otolaryngology Physician",
        "LicenseNumber": "71825",
        "LicenseNumberStateCode": "TN",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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