Provider Demographics
NPI:1104850411
Name:JHAVERI, RAJIV M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJIV
Middle Name:M
Last Name:JHAVERI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11510 GEORGIA AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1925
Mailing Address - Country:US
Mailing Address - Phone:301-946-5100
Mailing Address - Fax:301-929-0348
Practice Address - Street 1:110 IRVING ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:301-946-5100
Practice Address - Fax:301-929-0348
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD33069207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0129OtherCAREFIRST BCBS
DC223179OtherKAISER
DC2892173OtherAETNA HMO
VA5717639Medicaid
DC7398020OtherAETNA NON HMO
VA288226OtherANTHEM BCBS
FL91261800Medicaid
DC535866OtherNCPPO
DC0129OtherCAREFIRST BCBS
DC009264C13Medicare ID - Type UnspecifiedTRAILBLAZER MEDICARE