Healthcare Provider Details
I. General information
NPI: 1013992874
Provider Name (Legal Business Name): RAKESH K JAIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/14/2005
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7101 JAHNKE RD SUITE 550
RICHMOND VA
23225
US
IV. Provider business mailing address
7101 JAHNKE RD STE 550
RICHMOND VA
23225-4017
US
V. Phone/Fax
- Phone: 804-560-8880
- Fax: 804-560-9577
- Phone: 804-560-8880
- Fax: 804-560-9577
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RI0011X |
| Taxonomy | Interventional Cardiology Physician |
| License Number | 0101041105 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 0101041105 |
| License Number State | VA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 0101041105 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: