Healthcare Provider Details

I. General information

NPI: 1114917770
Provider Name (Legal Business Name): RAJESH K KHURANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 01/30/2025
Certification Date: 01/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

382 ECHO LN
FAYETTEVILLE NC
28303-4667
US

IV. Provider business mailing address

382 ECHO LN
FAYETTEVILLE NC
28303-4667
US

V. Phone/Fax

Practice location:
  • Phone: 910-323-1718
  • Fax: 910-323-3834
Mailing address:
  • Phone: 910-309-0343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9500970
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: