Provider Demographics
NPI:1376596692
Name:RAYANI, CHOUDHARY V (MD)
Entity Type:Individual
Prefix:
First Name:CHOUDHARY
Middle Name:V
Last Name:RAYANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:90 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:740-446-5002
Mailing Address - Fax:740-446-5883
Practice Address - Street 1:100 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5002
Practice Address - Fax:740-446-5883
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.076468207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000181871OtherUNISON MEDICAID
001714112OtherMOUNTAIN STATE BCBS
OH2129119OtherMOLINA MEDICAID
OH310917085102OtherCARESOURCE MEDICAID
000000198628OtherANTHEM BCBS
WV6000247000Medicaid
110188651OtherRR MEDICARE
OH0887383Medicare PIN