MEDICARE: RAJIV RANJAN 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	207RC0000X	Cardiovascular Disease Physician	23414	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	30328	OTHER	NE	BCBSNE
2	9394821	OTHER	NE	PHCS
3	P00261091	OTHER	NE	RR

General Provider Information

NPI Number	:	1679520225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJIV RANJAN M.D.

Provider Business Mailing Address
First Line	:	110 N 29TH ST
Second Line	:	STE. 301
City	:	NORFOLK
State	:	NE
Zip	:	68701-4461
Country	:	US
Telephone Number	:	402-844-8284
Fax Number	:	402-644-7505

Provider Business Practice Location Address
First Line	:	110 N 29TH ST
Second Line	:	STE. 301
City	:	NORFOLK
State	:	NE
Zip	:	68701-4461
Country	:	US
Telephone Number	:	402-844-8284
Fax Number	:	402-644-7505

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

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	01/11/2008

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Directions to “ RAJIV RANJAN M.D.” Practice Location

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