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General NPI Number Information
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NPI Number | 1982659702
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Entity Type | Individual
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Provider Name | RAJAPPA EKAMBARAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 04/09/2020
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Provider Practice Location Address
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Address Line | 4717 UNIVERSITY DR NW STE 109
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City | HUNTSVILLE
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State | AL
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Zip | 35816-3460
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Country | US
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Telephone | 256-890-8700
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Fax | 256-890-8989
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Provider Business Mailing Address
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Address Line | 4717 UNIVERSITY DR NW STE 109
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City | HUNTSVILLE
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State | AL
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Zip | 35816-3460
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Country | US
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Telephone | 256-890-8700
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Fax | 256-890-8989
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | AL10375
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License Number State | AL
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