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General NPI Number Information
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NPI Number | 1366448631
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Entity Type | Individual
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Provider Name | RAJ K MATURI MD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 11220 ILLINOIS ST STE 110
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City | CARMEL
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State | IN
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Zip | 46032-8887
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Country | US
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Telephone | 317-817-1414
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Fax | 317-805-4587
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Provider Business Mailing Address
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Address Line | 10300 N ILLINOIS STREET SUITE 1060
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1167
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Country | US
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Telephone | 317-817-1414
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Fax | 317-805-4587
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 01050295
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 01050295
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License Number State | IN
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