MEDICARE: RAJINI SURENDRA 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	207R00000X	Internal Medicine Physician	2008-00087	NC

General Provider Information

NPI Number	:	1679720544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJINI SURENDRA MD

Provider Business Mailing Address
First Line	:	8600 ISLE WORTH CT APT 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-6257
Country	:	US
Telephone Number	:	919-251-8388
Fax Number	:

Provider Business Practice Location Address
First Line	:	8600 ISLE WORTH CT APT 102
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27617-6257
Country	:	US
Telephone Number	:	919-251-8388
Fax Number	:

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

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	08/22/2008

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