Provider Demographics
NPI:1265434633
Name:SUVARNA, RAJENDRA KUMAR (MD)
Entity type:Individual
Prefix:
First Name:RAJENDRA
Middle Name:KUMAR
Last Name:SUVARNA
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 1:202 N DIVISION ST
Mailing Address - Street 2:MULTICARE AUBURN MEDICAL CENTER
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4939
Mailing Address - Country:US
Mailing Address - Phone:253-333-2562
Mailing Address - Fax:253-333-2622
Practice Address - Street 1:202 N DIVISION ST
Practice Address - Street 2:MULTICARE AUBURN MEDICAL CENTER
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-333-2562
Practice Address - Fax:253-333-2622
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9906207R00000X, 208M00000X
WAMD60092350207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018474Medicaid
NV002018474Medicaid
NV100672Medicare PIN
NVV100672Medicare PIN