Provider Demographics
NPI:1275630097
Name:MASIH, RAJAN (MD)
Entity Type:Individual
Prefix:
First Name:RAJAN
Middle Name:
Last Name:MASIH
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:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847-0365
Mailing Address - Country:US
Mailing Address - Phone:304-257-4204
Mailing Address - Fax:
Practice Address - Street 1:712 N MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-1092
Practice Address - Country:US
Practice Address - Phone:304-530-4999
Practice Address - Fax:304-257-4204
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19166207P00000X
MT8173207P00000X
NE20646207P00000X
WI97402207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine