Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 58188 | AZ |
Y | 207RC0000X | Internist - Cardiovascular Disease | 58188 | AZ |
NPI | 1871742502 |
---|---|
Provider Name | Dr. Rajakrishnan Vijayakrishnan |
First Address | Phoenix, AZ 85013-4220 |
Second Address | Phoenix, AZ 85013-4294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2008 |
Last Update Date | 01/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201313540 | (05) | IN |
7100362300 | (05) | KY |