Provider Demographics
NPI:1023108321
Name:RAJAGOPALAN, KUMAR (MD)
Entity type:Individual
Prefix:
First Name:KUMAR
Middle Name:
Last Name:RAJAGOPALAN
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 1:1 FEDERAL ST # 200
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1088
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:900 CENTENNIAL BLVD STE M
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4637
Practice Address - Country:US
Practice Address - Phone:856-325-6750
Practice Address - Fax:856-325-6777
Is Sole Proprietor?:No
Enumeration Date:2006-10-15
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA075874207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
010005989OtherAMERICHOICE
1791008OtherUNITED HEALTHCARE
3456939OtherAETNA
P00138412OtherRR MEDCIARE
P3191514OtherOXFORD
NJ0026794Medicaid
38625OtherUNIVERSITY HEALTHPLAN
2308701000OtherAMERIHEALTH, KEYSTONE, IBC
60005740OtherHORIZON NJ HEALTH
1633318OtherAMERIHEALTH PPO
3K5927OtherHEALTHNET
1791008OtherUNITED HEALTHCARE
P3191514OtherOXFORD