Provider Demographics
NPI:1922142819
Name:RAI, ASHOK (MD)
Entity Type:Individual
Prefix:
First Name:ASHOK
Middle Name:
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 1:188 W NORTHERN LIGHTS BLVD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3902
Mailing Address - Country:US
Mailing Address - Phone:907-771-3857
Mailing Address - Fax:907-278-8052
Practice Address - Street 1:3260 PROVIDENCE DR STE 523
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4608
Practice Address - Country:US
Practice Address - Phone:907-222-1714
Practice Address - Fax:907-222-1740
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4528208600000X
CAC132080208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1523Medicaid
CAPENDINGMedicare PIN
AKMD1523Medicaid