Provider Demographics
NPI:1952440141
Name:RAJADHYAKSHA, DILIP PRABHAKAR (MD)
Entity Type:Individual
Prefix:
First Name:DILIP
Middle Name:PRABHAKAR
Last Name:RAJADHYAKSHA
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 1:11 OLD BROOK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545
Mailing Address - Country:US
Mailing Address - Phone:508-842-5097
Mailing Address - Fax:
Practice Address - Street 1:123 SUMMER STREET
Practice Address - Street 2:SAINT VINCENT HOSPITAL ANESTHESIA DEPT
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608
Practice Address - Country:US
Practice Address - Phone:508-363-6030
Practice Address - Fax:508-363-9395
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA37602207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology