Provider Demographics
NPI:1558546432
Name:TENDULKAR, RAHUL DILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:DILIP
Last Name:TENDULKAR
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 1:9500 EUCLID AVE
Mailing Address - Street 2:DESK T-28
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-445-9869
Mailing Address - Fax:216-445-1068
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:DESK T-28
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-1942
Practice Address - Fax:216-445-1068
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0911892085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2830511Medicaid
OHTE7385431Medicare PIN