MR. MAHENDRA C MARU M.D. NPI 1891792818

NPI Information

NPI: 1891792818
Provider Name: MR. MAHENDRA C MARU, M.D.
Classification: Internal Medicine - 207RN0300X
Entity Type: Individual

Specialization: Nephrology

PECOS Registration: Yes

CLIA Number: 18D0881567

Address:
1930 E PARRISH AVE
OWENSBORO, KY
ZIP 42303
Phone: (270) 689-1919
Get Directions

MR. Mahendra C Maru, M.D. is a nephrology internal medicine in Owensboro, KY. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. MR. Mahendra C Maru, M.D. NPI is 1891792818. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1930 E PARRISH AVE
OWENSBORO, KY
ZIP 42303-443
Phone: (270) 689-1919
Fax: (270) 689-1990

The NPI 1891792818 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 18D0881567 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/5/2005 and was last updated on 6/23/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207R00000X	Internal Medicine		33042	KENTUCKY	No
2	207RN0300X	Internal Medicine	Nephrology	33042	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	CJ7612	OTHER	KENTUCKY	RAILROAD MEDICARE
2	CJ7612	OTHER	INDIANA	RAILROAD MEDICARE
3	189210	MEDICARE PIN	INDIANA
4	0635002	MEDICARE PIN	KENTUCKY
5	200145790	MEDICAID	INDIANA
6	64330426	MEDICAID	KENTUCKY
7	000000067006	OTHER	KENTUCKY	ANTHEM
8	249200B	MEDICARE PIN	INDIANA
9	000000067006	OTHER	INDIANA	ANTHEM PIN
10	H12883	MEDICARE UPIN	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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