Provider Demographics
NPI:1124245618
Name:NATARAJAN, NAGENDRA (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:NAGENDRA
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 241578
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-5578
Mailing Address - Country:US
Mailing Address - Phone:402-334-4773
Mailing Address - Fax:
Practice Address - Street 1:7500 MERCY RD STE 1300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2319
Practice Address - Country:US
Practice Address - Phone:402-334-4773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE29095207RH0003X
NE5155207R00000X, 208000000X
MO2012014545207RH0003X
KY42699207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1124245618Medicaid
MO1124245618Medicaid