Provider Demographics
NPI:1013992874
Name:JAIN, RAKESH K (MD)
Entity Type:Individual
Prefix:
First Name:RAKESH
Middle Name:K
Last Name:JAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7101 JAHNKE RD
Mailing Address - Street 2:SUITE 550
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225
Mailing Address - Country:US
Mailing Address - Phone:804-560-8880
Mailing Address - Fax:804-560-9577
Practice Address - Street 1:7101 JAHNKE RD
Practice Address - Street 2:SUITE 550
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225
Practice Address - Country:US
Practice Address - Phone:804-560-8880
Practice Address - Fax:804-560-9577
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101041105207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD09666Medicare UPIN
VA00V524V81Medicare ID - Type Unspecified