Provider Demographics
NPI:1891902268
Name:RAJ & PUSHMA SAMTANI MDPC
Entity Type:Organization
Organization Name:RAJ & PUSHMA SAMTANI MDPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAMTANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-868-3003
Mailing Address - Street 1:9131 PISCATAWAY RD
Mailing Address - Street 2:280
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2508
Mailing Address - Country:US
Mailing Address - Phone:301-868-3003
Mailing Address - Fax:
Practice Address - Street 1:9131 PISCATAWAY RD
Practice Address - Street 2:280
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2508
Practice Address - Country:US
Practice Address - Phone:301-868-3003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD27744207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC53520001OtherBLUE CROSS
MD=========OtherAETNA
MD=========OtherUNITED HEALTH CARE
MD655683Medicare ID - Type Unspecified
DC655683Medicare ID - Type Unspecified