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General NPI Number Information
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NPI Number | 1275704298
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Entity Type | Individual
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Provider Name | DHARMAPAUL LAKSHMANA RAJU MD, FRCPC, FASN
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Gender | Male
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 1970 ROANOKE BLVD
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City | SALEM
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State | VA
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Zip | 24153-6404
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Country | US
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Telephone | 540-982-2463
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Fax | 540-224-1963
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Provider Business Mailing Address
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Address Line | 1970 ROANOKE BLVD
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City | SALEM
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State | VA
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Zip | 24153-6404
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Country | US
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Telephone | 540-982-2463
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Fax | 540-224-1963
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD60601055
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | A100720
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License Number State | CA
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