Provider Demographics
NPI:1922306497
Name:RAJ, SUNDAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNDAR
Middle Name:
Last Name:RAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:H.N.
Other - Middle Name:
Other - Last Name:SUNDAR RAJ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1221 N DECATUR BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-1245
Mailing Address - Country:US
Mailing Address - Phone:702-785-3005
Mailing Address - Fax:
Practice Address - Street 1:1221 N DECATUR BLVD
Practice Address - Street 2:STE 5
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2497
Practice Address - Country:US
Practice Address - Phone:702-785-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMD 4121208D00000X
NV4121207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine