MEDICARE: DR. RAVI RAJPOOT MD

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	2085R0202X	Diagnostic Radiology Physician	A141752	CA
2	2085R0202X	Diagnostic Radiology Physician	35.155789	OH
3	2085R0202X	Diagnostic Radiology Physician	036154512	IL
4	2085R0202X	Diagnostic Radiology Physician	D0107032	MD

General Provider Information

NPI Number	:	1255750410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVI RAJPOOT MD

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-6423
Fax Number	:

Provider Business Practice Location Address
First Line	:	4940 EASTERN AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21224-2735
Country	:	US
Telephone Number	:	410-955-5000
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	05/19/2026

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