Provider Demographics
NPI:1871568048
Name:KATHURIA, RAJEEV S (MD)
Entity type:Individual
Prefix:DR
First Name:RAJEEV
Middle Name:S
Last Name:KATHURIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8402 E SHEA BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6635
Mailing Address - Country:US
Mailing Address - Phone:480-661-0700
Mailing Address - Fax:480-778-9200
Practice Address - Street 1:8402 E SHEA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6635
Practice Address - Country:US
Practice Address - Phone:480-661-0700
Practice Address - Fax:480-778-9200
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21778208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0776040OtherBC/BS OF ARIZONA
AZ2Z2558OtherHEALTHNET
AZ995225000013OtherTMG-SUN HEALTH
AZP00249196OtherRAILROAD MEDICARE
AZ152132Medicaid
AZF64940Medicare UPIN
AZ103980Medicare ID - Type Unspecified