MEDICARE: RAJENDRA K. MOTWANI DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	3478	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013950740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJENDRA K. MOTWANI DO

Provider Business Mailing Address
First Line	:	9817 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2812
Country	:	US
Telephone Number	:	405-632-4500
Fax Number	:	405-632-7500

Provider Business Practice Location Address
First Line	:	9817 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2812
Country	:	US
Telephone Number	:	405-632-4500
Fax Number	:	405-632-7500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	06/16/2016

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