Provider Demographics
NPI:1467849422
Name:RAJIV SIDDARAMU MD PLLC
Entity Type:Organization
Organization Name:RAJIV SIDDARAMU MD PLLC
Other - Org Name:BLUPEAK HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:
Authorized Official - Last Name:SIDDARAMU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-753-8120
Mailing Address - Street 1:3219 E CAMELBACK RD # 224
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2307
Mailing Address - Country:US
Mailing Address - Phone:602-753-8120
Mailing Address - Fax:
Practice Address - Street 1:9700 N 91ST ST STE A115
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5036
Practice Address - Country:US
Practice Address - Phone:602-753-8120
Practice Address - Fax:602-801-3865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty