Healthcare Provider Details

I. General information

NPI: 1194258384
Provider Name (Legal Business Name): RAKESH NITIN CHOPDE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2017
Last Update Date: 11/09/2023
Certification Date: 11/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15204 OMEGA DR STE 100
ROCKVILLE MD
20850-4812
US

IV. Provider business mailing address

9901 MEDICAL CENTER DR
ROCKVILLE MD
20850-3357
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-6750
  • Fax: 301-208-8953
Mailing address:
  • Phone: 240-826-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberR76025
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0093665
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0093665
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: