MEDICARE: RAKESH MALHOTRA M.D.

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	207R00000X	Internal Medicine Physician	MD417683	PA

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	:	1073519666
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAKESH MALHOTRA M.D.

Provider Business Mailing Address
First Line	:	3026 MOSSAR DR
Second Line	:	LEHIGH VALLEY PRIM CARE PC
City	:	ALLENTOWN
State	:	PA
Zip	:	18102
Country	:	US
Telephone Number	:	484-538-1834
Fax Number	:

Provider Business Practice Location Address
First Line	:	LEHIGH VALLEY PRIMARY CARE
Second Line	:	3026 MOSSER DR
City	:	ALLENTOWN
State	:	PA
Zip	:	18103
Country	:	US
Telephone Number	:	484-538-1834
Fax Number	:

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

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	12/07/2022

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