Provider Demographics
NPI:1639231004
Name:NAIK, RAJESH (RPH)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:NAIK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 LOCKERLY PASS
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-4340
Mailing Address - Country:US
Mailing Address - Phone:770-630-4037
Mailing Address - Fax:404-524-9999
Practice Address - Street 1:209 EDGEWOOD AVE SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-3012
Practice Address - Country:US
Practice Address - Phone:770-630-4037
Practice Address - Fax:404-524-9999
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH015951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARPH015951OtherR.PH LICENCE #