Healthcare Provider Details

I. General information

NPI: 1033194766
Provider Name (Legal Business Name): ANUJA RASTOGI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2005
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9901 MEDICAL CENTER DR PEDIATRIC FLOOR
ROCKVILLE MD
20850-3357
US

IV. Provider business mailing address

1500 CONCORD TER PEDIATRIX MEDICAL GROUP, INC
SUNRISE FL
33323-2815
US

V. Phone/Fax

Practice location:
  • Phone: 240-826-6480
  • Fax:
Mailing address:
  • Phone: 800-243-3839
  • Fax: 202-476-3573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD62745
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number35515
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: