Provider Demographics
NPI:1821079500
Name:NARULA, RAJESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:K
Last Name:NARULA
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 1:500 W BROADWAY ST 4TH FLOOR
Mailing Address - Street 2:PROVIDENCE NEPH OF MT
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4096
Mailing Address - Country:US
Mailing Address - Phone:406-327-1918
Mailing Address - Fax:406-549-2246
Practice Address - Street 1:1380 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5215
Practice Address - Country:US
Practice Address - Phone:405-737-0881
Practice Address - Fax:405-737-0899
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK207RN0300X207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100017630AMedicaid
OK200028420AMedicaid
OK731570351-001OtherBCBS DR PROVIDER
OK731602722-001OtherBCBS GROUP ID
OK731602722-001OtherBCBS GROUP ID
OKG07377Medicare UPIN
OK248432202Medicare ID - Type UnspecifiedMEDICARE