Provider Demographics
NPI:1245287093
Name:RAJAN, BINDU E (MD)
Entity type:Individual
Prefix:
First Name:BINDU
Middle Name:E
Last Name:RAJAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19875 N 51ST AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5114
Mailing Address - Country:US
Mailing Address - Phone:623-581-8998
Mailing Address - Fax:623-581-6461
Practice Address - Street 1:19875 N 51ST AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-5114
Practice Address - Country:US
Practice Address - Phone:623-581-8998
Practice Address - Fax:623-581-6461
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30750207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ118930Medicare PIN
AZZ118926Medicare PIN
AZH71884Medicare UPIN