MEDICARE: LEAH RAJ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0011X	Interventional Cardiology Physician	77510	GA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RI0011X	Interventional Cardiology Physician	65365	TN
4	207R00000X	Internal Medicine Physician	148883	CA
5	207R00000X	Internal Medicine Physician	7052	GA
6	207R00000X	Internal Medicine Physician	77510	GA
7	207RC0000X	Cardiovascular Disease Physician	148883	CA
8	207RC0000X	Cardiovascular Disease Physician	77510	GA

General Provider Information

NPI Number	:	1053730044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEAH RAJ MD

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 THE VANDERBILT CLINIC
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-1352
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	08/03/2022

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