MEDICARE: LAXMI NARAYANA RAJU BUDDHARAJU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	21789	NE
2	207RX0202X	Medical Oncology Physician	21789	NE

General Provider Information

NPI Number	:	1184604993
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAXMI NARAYANA RAJU BUDDHARAJU M.D.

Provider Business Mailing Address
First Line	:	98102 NEBRASKA MEDICAL CENTER
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-8102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 S. 48TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68198-0001
Country	:	US
Telephone Number	:	402-559-5600
Fax Number	:	402-559-6615

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	10/16/2018

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