Provider Demographics
NPI:1942253992
Name:NATARAJAN, MONIKA (MD)
Entity type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 UNION AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-6655
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7645 WOLF RIVER CIR STE 100
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1751
Practice Address - Country:US
Practice Address - Phone:901-405-0275
Practice Address - Fax:901-869-2908
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35399207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
470882104OtherUNITED HEALTHCARE
7608293OtherAETNA
470882104OtherTRICARE
TN4052154OtherBCBS OF TENNESSEE
7254795OtherCIGNA
TN3867904Medicaid
H47737OtherHEALTHSPRINGS
32093OtherTLC
3867904Medicare PIN
32093OtherTLC
7608293OtherAETNA
TN3867904Medicaid