Provider Demographics
NPI:1295093946
Name:MAHENDRARAJ, KRISHNARAJ (MD)
Entity type:Individual
Prefix:
First Name:KRISHNARAJ
Middle Name:
Last Name:MAHENDRARAJ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:640 S STATE ST # MC3055
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-3530
Mailing Address - Country:US
Mailing Address - Phone:302-674-4070
Mailing Address - Fax:302-672-2315
Practice Address - Street 1:724 S NEW ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3540
Practice Address - Country:US
Practice Address - Phone:302-674-4070
Practice Address - Fax:302-672-2315
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC1-0025691208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery