MEDICARE: DR. ARCHANA RASTOGI 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	207Q00000X	Family Medicine Physician	00021023	AL
2	207R00000X	Internal Medicine Physician	00021023	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	051558657	OTHER	AL	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51005125	OTHER	AL	BLUE CROSS BLUE SHIELD
2	51005127	OTHER	AL	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427047885
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARCHANA RASTOGI M.D.

Provider Business Mailing Address
First Line	:	7583 WALL TRIANA HWY
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35757-8327
Country	:	US
Telephone Number	:	256-830-5777
Fax Number	:	256-546-2981

Provider Business Practice Location Address
First Line	:	5107 MOORES MILL RD
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811-1007
Country	:	US
Telephone Number	:	256-851-7190
Fax Number	:	256-851-7189

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	03/23/2015

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Directions to “ DR. ARCHANA RASTOGI M.D.” Practice Location

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