Basic Information
| Provider Information | |||||||||
| NPI: | 1427256098 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NARAYANRAO | ||||||||
| FirstName: | VIJAYARAJAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 415 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WILKES BARRE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 187024411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5702085571 | ||||||||
| FaxNumber: | 5702085548 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 W WOOSTER ST | ||||||||
| Address2: | |||||||||
| City: | BOWLING GREEN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 434022603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4193548900 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.089961 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.