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NPI Code Detail

MEDICARE: MR. RAJEWENI KUMAR GOVINDU OTR

MEDICARE: MR. RAJEWENI KUMAR GOVINDU OTR
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
1225X00000XOccupational Therapist05758MD

General Provider Information

NPI Number : 1346585668
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RAJEWENI KUMAR GOVINDU OTR
Provider Business Mailing Address
First Line : 200 NORTHPOINTE CIR STE 200
Second Line :
City : SEVEN FIELDS
State : PA
Zip : 16046-7861
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 520 KERR AVE
Second Line :
City : DENTON
State : MD
Zip : 21629-1343
Country : US
Telephone Number : 410-479-2130
Fax Number : 410-479-0396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2012
Last Update Date : 11/28/2012

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