Provider Demographics
NPI:1609841907
Name:BAKHSHI, RAJA M (MD)
Entity type:Individual
Prefix:DR
First Name:RAJA
Middle Name:M
Last Name:BAKHSHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:303 35TH ST
Mailing Address - Street 2:STE 102
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451
Mailing Address - Country:US
Mailing Address - Phone:757-425-1354
Mailing Address - Fax:757-425-7180
Practice Address - Street 1:303 35TH ST
Practice Address - Street 2:STE 102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451
Practice Address - Country:US
Practice Address - Phone:757-395-6900
Practice Address - Fax:757-425-7180
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101235852207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010061580Medicaid
VA010061580Medicaid
I03997Medicare UPIN