Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 221551 | NY |
N | 207P00000X | Emergency Physician | 38676 | SC |
N | 207P00000X | Emergency Physician | 42779 | KY |
Y | 207RI0200X | Infectious Disease | 38676 | SC |
NPI | 1063427532 |
---|---|
Provider Name | Rajeev K Bais |
First Address | Atlanta, GA 30374-3904 |
Second Address | Columbia, SC 29203-6833 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2006 |
Last Update Date | 09/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02639105 | (05) | NY |
386763 | (05) | SC |
H92564 | (02) | NY |
K015850 | MEDICARE PTAN - NICC (01) | KY |