Provider Demographics
NPI:1659383073
Name:RAHEJA, ARVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARVIN
Middle Name:
Last Name:RAHEJA
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 1:210 LADEAN CT
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29680-8795
Mailing Address - Country:US
Mailing Address - Phone:864-962-9945
Mailing Address - Fax:864-962-0957
Practice Address - Street 1:210 LADEAN CT
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:SC
Practice Address - Zip Code:29680-6795
Practice Address - Country:US
Practice Address - Phone:864-962-9945
Practice Address - Fax:864-962-0957
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11161207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC111612Medicaid
C68764Medicare UPIN
SCC687647310Medicare ID - Type Unspecified