Provider Demographics
NPI:1467624387
Name:KAVATHEKAR, RAHUL H (MD)
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:H
Last Name:KAVATHEKAR
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 1:1 VETERANS DR
Mailing Address - Street 2:GENERAL INTERNAL MEDICINE
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-467-2677
Mailing Address - Fax:612-467-2118
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:GENERAL INTERNAL MEDICINE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-2677
Practice Address - Fax:612-467-2118
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine