Provider Demographics
NPI:1184627333
Name:DAVE, RAJESH MUKUNDRAI (MD)
Entity type:Individual
Prefix:DR
First Name:RAJESH
Middle Name:MUKUNDRAI
Last Name:DAVE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:205 GRANDVIEW AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1708
Mailing Address - Country:US
Mailing Address - Phone:717-724-6450
Mailing Address - Fax:717-724-6451
Practice Address - Street 1:875 POPLAR CHURCH RD
Practice Address - Street 2:SUITE 400
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2203
Practice Address - Country:US
Practice Address - Phone:717-724-6450
Practice Address - Fax:717-724-6451
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-06-01
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Provider Licenses
StateLicense IDTaxonomies
PAMD063617L207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018507080001Medicaid
060067311OtherRAILROAD MEDICARE
H26538Medicare UPIN
050277EC5Medicare PIN