Provider Demographics
NPI:1942753116
Name:DR.RAWJI MD OB-GYNLLC
Entity Type:Organization
Organization Name:DR.RAWJI MD OB-GYNLLC
Other - Org Name:DR RAWJI MD OB-GYN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUSSAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAWJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-337-3190
Mailing Address - Street 1:850 W PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-3284
Mailing Address - Country:US
Mailing Address - Phone:386-337-3190
Mailing Address - Fax:386-337-3189
Practice Address - Street 1:850 W PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-3284
Practice Address - Country:US
Practice Address - Phone:386-337-3190
Practice Address - Fax:386-337-3189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-25
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME65279OtherLICESNSE
FLME65279OtherLICESNSE