Provider Demographics
NPI:1326013038
Name:MATHUR, RAKESH K (MD)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:K
Last Name:MATHUR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2112 BEL AIR RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2786
Mailing Address - Country:US
Mailing Address - Phone:410-877-8550
Mailing Address - Fax:410-877-8551
Practice Address - Street 1:2112 BEL AIR RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047
Practice Address - Country:US
Practice Address - Phone:410-877-8550
Practice Address - Fax:410-877-8551
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2013-07-29
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Provider Licenses
StateLicense IDTaxonomies
MDD0039170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD279700300Medicaid
MD279700300Medicaid
MD797QMedicare ID - Type Unspecified