Healthcare Provider Details

I. General information

NPI: 1437489770
Provider Name (Legal Business Name): RAJEEV SRIVASTAVA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 03/20/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E CARROLL ST
SALISBURY MD
21801-5422
US

IV. Provider business mailing address

600 MED DR
HAMPTON VA
23666
US

V. Phone/Fax

Practice location:
  • Phone: 410-546-6400
  • Fax:
Mailing address:
  • Phone: 757-788-0627
  • Fax: 757-788-0934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC176037
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0101256609
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD93495
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: