Provider Demographics
NPI:1346213824
Name:RAI, RUDRAJIT MASAND (MD)
Entity Type:Individual
Prefix:
First Name:RUDRAJIT
Middle Name:MASAND
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 1:7120 MINSTREL WAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-5248
Mailing Address - Country:US
Mailing Address - Phone:410-290-6677
Mailing Address - Fax:410-290-6676
Practice Address - Street 1:7120 MINSTREL WAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5248
Practice Address - Country:US
Practice Address - Phone:410-290-6677
Practice Address - Fax:410-290-6676
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11447207RG0100X
MDD44427207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD282701800Medicaid
MD282701800Medicaid
MD204P462GMedicare PIN