Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 0101041105 | VA |
Y | 207RI0011X | Interventional Cardiology | 0101041105 | VA |
NPI | 1013992874 |
---|---|
Provider Name | Rakesh K Jain |
First Address | Richmond, VA 23225 |
Second Address | Richmond, VA 23225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 20/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D09666 | (02) | VA |