Provider Demographics
NPI:1134457898
Name:TAYAL, RAJIV (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:RAJIV
Middle Name:
Last Name:TAYAL
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9530 COSNER DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-7760
Mailing Address - Country:US
Mailing Address - Phone:540-373-1331
Mailing Address - Fax:540-373-1124
Practice Address - Street 1:9530 COSNER DR
Practice Address - Street 2:SUITE 200
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-7760
Practice Address - Country:US
Practice Address - Phone:540-373-1331
Practice Address - Fax:540-373-1124
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256393207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1134457898Medicaid
VAVVF057AMedicare PIN
NJ0248398Medicaid