Provider Demographics
NPI:1467470229
Name:RAJUPET, KAMALA (MD)
Entity Type:Individual
Prefix:
First Name:KAMALA
Middle Name:
Last Name:RAJUPET
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 1:356 FREEPORT ST
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6071
Mailing Address - Country:US
Mailing Address - Phone:724-367-2400
Mailing Address - Fax:724-367-2401
Practice Address - Street 1:356 FREEPORT ST
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6071
Practice Address - Country:US
Practice Address - Phone:724-367-2400
Practice Address - Fax:724-367-2401
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-063193-L207RE0101X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001817650Medicaid
PA181765001Medicaid
PAH23312Medicare UPIN