Provider Demographics
NPI:1447477799
Name:SHOOR, RAJESH (DO)
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:SHOOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-2746
Mailing Address - Country:US
Mailing Address - Phone:603-432-1500
Mailing Address - Fax:603-926-2853
Practice Address - Street 1:1 PARKLAND DR
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2746
Practice Address - Country:US
Practice Address - Phone:603-421-2344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH13883207R00000X
NY235934208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH04Y012866NH01OtherANTHEM BC BS NH
NHP00630882OtherRAILROAD MEDICARE
MA2150841Medicaid
NH30226565Medicaid
NHAA111634OtherHARVARD
MA1447477799OtherBMC HEALTHNET
NH04Y012866NH01OtherANTHEM BC BS NH