Provider Demographics
NPI:1659373942
Name:KATTAR, RAJENDRA R (MD)
Entity Type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:R
Last Name:KATTAR
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 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:419-842-3000
Mailing Address - Fax:419-291-9883
Practice Address - Street 1:2940 N MCCORD RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1753
Practice Address - Country:US
Practice Address - Phone:419-842-3000
Practice Address - Fax:419-842-3042
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301073252207RC0000X
OH35074719K207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00711884OtherRRMC
OH2081250Medicaid
OH0865125Medicare PIN
OHG05095Medicare UPIN
MI23450011Medicare PIN
OH4011024Medicare PIN
OH4011029Medicare PIN
OH4133502Medicare PIN
OH060054809Medicare PIN
G05095Medicare UPIN
OH2081250Medicaid
MI0N23450Medicare PIN
OH0865129Medicare PIN
OH4011022Medicare PIN
OH0865121Medicare PIN
P00711884OtherRRMC
OH4011021Medicare PIN
OH0865127Medicare PIN
MIMI1635010Medicare PIN