Provider Demographics
NPI:1013973213
Name:RAJA, FURQAN F (MD)
Entity type:Individual
Prefix:
First Name:FURQAN
Middle Name:F
Last Name:RAJA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:70 JUNGERMANN CIRCLE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376
Mailing Address - Country:US
Mailing Address - Phone:636-720-0310
Mailing Address - Fax:636-720-0311
Practice Address - Street 1:70 JUNGERMANN CIRCLE
Practice Address - Street 2:SUITE 405
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376
Practice Address - Country:US
Practice Address - Phone:636-720-0310
Practice Address - Fax:636-720-0311
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2015-03-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN47257207R00000X, 207RN0300X
WI51102-20207RN0300X
MO2010032833207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000014027Medicare UPIN