Provider Demographics
NPI:1801341755
Name:BHADRA, RAJARSHI (MD)
Entity type:Individual
Prefix:
First Name:RAJARSHI
Middle Name:
Last Name:BHADRA
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 1:5981 JEFFERSON ST NE STE A
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-3457
Mailing Address - Country:US
Mailing Address - Phone:505-370-9600
Mailing Address - Fax:575-627-5835
Practice Address - Street 1:5981 JEFFERSON ST NE STE A
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3457
Practice Address - Country:US
Practice Address - Phone:505-370-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2021-0236207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMMD2021-0236OtherSTATE LICENSE