Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD037866 | DC |
NPI | 1043231285 |
---|---|
Provider Name | Dominic Raj |
First Address | Washington, DC 20037-3201 |
Second Address | Washington, DC 20037-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 02/06/2009 |