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General NPI Number Information
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NPI Number | 1134336563
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Entity Type | Individual
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Provider Name | RAJESH SHIVAJI KADAM M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 1570 WAVERLY RD
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City | KINGSPORT
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State | TN
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Zip | 37664-2523
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Country | US
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Telephone | 423-224-1300
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Fax | 423-224-1375
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Provider Business Mailing Address
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Address Line | 1167 SPRATLIN PARK DR
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City | GRAY
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State | TN
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Zip | 37615-6205
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Country | US
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Telephone | 423-467-3724
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Fax | 423-467-3644
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | 517
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 517
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101241538
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 42576
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License Number State | TN
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