Provider Demographics
NPI:1386677938
Name:RAJA, VINAY (MD)
Entity Type:Individual
Prefix:
First Name:VINAY
Middle Name:
Last Name:RAJA
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 1:11300 CORPORATE AVE STE 330
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1355
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2750 CLAY EDWARDS DR STE 215
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3256
Practice Address - Country:US
Practice Address - Phone:913-574-1050
Practice Address - Fax:913-574-1055
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0428985207RH0003X, 207RH0003X
IN01049900A207RH0003X
MO2002017799207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200404100BMedicaid
MO1386677938Medicaid
KSP00953229Medicare PIN
H80401Medicare UPIN
KS200404100BMedicaid