Provider Demographics
NPI:1942301403
Name:RAJVANSHI, AMIT KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:KUMAR
Last Name:RAJVANSHI
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 1:9461 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4633
Mailing Address - Country:US
Mailing Address - Phone:301-881-0230
Mailing Address - Fax:301-770-0207
Practice Address - Street 1:121 CONGRESSIONAL LN
Practice Address - Street 2:SUITE 409
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1542
Practice Address - Country:US
Practice Address - Phone:301-881-0230
Practice Address - Fax:301-770-0207
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0037891207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD401255100Medicaid
DC025915400Medicaid
MD401255100Medicaid
MDG02482A01Medicare PIN