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NPI Code Detail

MEDICARE: PERUMALSWAMY RAJARAM MD

MEDICARE:   PERUMALSWAMY  RAJARAM  MD
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
1208600000XSurgery PhysicianME40960FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770597569
Entity Type Code : Individual
Provider Name (Legal Business Name) : PERUMALSWAMY RAJARAM MD
Provider Business Mailing Address
First Line : 321 E ROBERTSON ST
Second Line :
City : BRANDON
State : FL
Zip : 33511-5253
Country : US
Telephone Number : 813-685-2191
Fax Number : 813-689-8755
Provider Business Practice Location Address
First Line : 40124 HIGHWAY 27 STE 104
Second Line :
City : DAVENPORT
State : FL
Zip : 33837-5905
Country : US
Telephone Number : 863-421-7626
Fax Number : 863-419-2421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2006
Last Update Date : 09/24/2019

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Directions to “ PERUMALSWAMY RAJARAM MD” Practice Location

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