Provider Demographics
NPI:1174910566
Name:NAGARAJAN, REGINA MELENDEZ (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:MELENDEZ
Last Name:NAGARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:REGINA
Other - Middle Name:MARIE
Other - Last Name:MELENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5003 S MIAMI BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-8589
Mailing Address - Country:US
Mailing Address - Phone:919-354-0840
Mailing Address - Fax:
Practice Address - Street 1:115 KILDAIRE PARK DR STE 402
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8144
Practice Address - Country:US
Practice Address - Phone:919-443-4100
Practice Address - Fax:877-904-9349
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT570752084P0800X
390200000X
NC2020-022402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program