MEDICARE: DR. RAJA S MEHDI 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	207RX0202X	Medical Oncology Physician	12720	NV
2	207RH0003X	Hematology & Oncology Physician	12720	NV

General Provider Information

NPI Number	:	1366441743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAJA S MEHDI MD

Provider Business Mailing Address
First Line	:	PO BOX 749495
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-9495
Country	:	US
Telephone Number	:	239-432-8331
Fax Number	:	813-321-1296

Provider Business Practice Location Address
First Line	:	6827 W TROPICANA AVE
Second Line	:	110
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4918
Country	:	US
Telephone Number	:	702-508-9128
Fax Number	:	702-302-4125

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

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	01/10/2023

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