Provider Demographics
NPI:1184863631
Name:RAI, PRADEEP (MD)
Entity Type:Individual
Prefix:DR
First Name:PRADEEP
Middle Name:
Last Name:RAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 RACE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-1116
Mailing Address - Country:US
Mailing Address - Phone:720-725-1564
Mailing Address - Fax:
Practice Address - Street 1:8181 E TUFTS AVE STE 560
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80237-2559
Practice Address - Country:US
Practice Address - Phone:866-990-8622
Practice Address - Fax:888-972-8592
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0054622207RA0401X, 208600000X
GA003499208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine