Provider Demographics
NPI:1467075853
Name:RAJPUT, MEDHAVI (MD)
Entity Type:Individual
Prefix:
First Name:MEDHAVI
Middle Name:
Last Name:RAJPUT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S FRONT ST, SUITE 3C UPMC PINNACLE, INTERNAL MEDICI
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104
Mailing Address - Country:US
Mailing Address - Phone:717-231-8506
Mailing Address - Fax:717-231-8535
Practice Address - Street 1:205 S FRONT ST, SUITE 3C UPMC PINNACLE, INTERNAL MEDICI
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104
Practice Address - Country:US
Practice Address - Phone:717-231-8506
Practice Address - Fax:717-231-8535
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT220389390200000X, 207RC0200X, 207RG0100X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist