Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 0101261994 | VA |
NPI | 1023372679 |
---|---|
Provider Name | Dr. Ajay S Rathore |
First Address | Newport News, VA 23601-1318 |
Second Address | Newport News, VA 23606-3562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2012 |
Last Update Date | 08/12/2017 |