Provider Demographics
NPI:1245799089
Name:RAJAGOPAL, AARABHI SRINIVAS (MD, FAAP)
Entity type:Individual
Prefix:
First Name:AARABHI
Middle Name:SRINIVAS
Last Name:RAJAGOPAL
Suffix:
Gender:
Credentials:MD, FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 S 2ND ST APT 403
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-2130
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1450
Practice Address - Country:US
Practice Address - Phone:612-365-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD477242208M00000X
MN74024208M00000X
WAMD.MD.61651557208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN74024OtherMINNESOTA STATE MEDICAL BOARD
PAMD477242OtherPA MEDICAL LICENSE
IL125.073598OtherILLINOIS STATE MEDICAL BOARD
WAMD.61651557OtherWASHINGTON MEDICAL COMMISSION
MN2U6882Medicaid