Provider Demographics
NPI:1891863130
Name:RAI, PRITHVIRAJ B (MD)
Entity Type:Individual
Prefix:
First Name:PRITHVIRAJ
Middle Name:B
Last Name:RAI
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:PO BOX 3339
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22402-3339
Mailing Address - Country:US
Mailing Address - Phone:855-739-9953
Mailing Address - Fax:
Practice Address - Street 1:1300 HOSPITAL DR STE 302
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-8451
Practice Address - Country:US
Practice Address - Phone:855-739-9953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2019-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0059730207RC0000X
VA0101258915207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAM106ZMedicare Oscar/Certification