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General NPI Number Information
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NPI Number | 1649372319
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Entity Type | Individual
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Provider Name | RAJESH GOVINDASAMY M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 300 STATE ST STE 207
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City | ERIE
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State | PA
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Zip | 16507-1429
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Country | US
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Telephone | 814-877-3696
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Fax | 814-877-3661
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Provider Business Mailing Address
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Address Line | 300 STATE ST STE 207
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City | ERIE
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State | PA
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Zip | 16507-1429
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Country | US
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Telephone | 814-877-3625
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Fax | 814-877-3661
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | MD418543
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD418543
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD 418543
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License Number State | PA
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