Basic Information
| Provider Information | |||||||||
| NPI: | 1316952807 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ARULANDU | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7002 W JOHNSON RD | ||||||||
| Address2: | |||||||||
| City: | LA PORTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463508289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2193250604 | ||||||||
| FaxNumber: | 2198791401 | ||||||||
| Practice Location | |||||||||
| Address1: | 7002 W JOHNSON RD | ||||||||
| Address2: | |||||||||
| City: | LA PORTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463508289 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2193250604 | ||||||||
| FaxNumber: | 2198791401 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 09/21/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 01053921 | IN | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200335060 | 05 | IN | MEDICAID | 000000201171 | 01 | IN | ANTHEM | OTHER |