Gandra, Jagjeevan Rao

Gandra, Jagjeevan Rao is an individual health care provider with primary practice located at 3723 Franklin St , Michigan City IN 46360-7310. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gandra, Jagjeevan Rao can be contacted via phone (219) 874-3313.

Contact Information

Primary practice address
3723 Franklin St Michigan City IN 46360-7310
Phone: (219) 874-3313
Fax: (219) 878-2330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01045405A Indiana

Profile Details

NPI number 1205821014
LBN Legal business name Gandra, Jagjeevan Rao
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Apr 13th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205821014 NPPES
Indiana MEDICAID 200096690
Indiana Other 000000371639

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