Provider Demographics
NPI:1376740589
Name:RAJENDRA, ANIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:
Last Name:RAJENDRA
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 1:3686 GRANDVIEW PKWY
Mailing Address - Street 2:SUITE 720
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-3407
Mailing Address - Country:US
Mailing Address - Phone:205-971-7500
Mailing Address - Fax:
Practice Address - Street 1:3686 GRANDVIEW PKWY
Practice Address - Street 2:SUITE 720
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-3407
Practice Address - Country:US
Practice Address - Phone:205-971-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL33967207R00000X, 207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease