Provider Demographics
NPI:1538352851
Name:RAJI, M REZA (MD, MPH)
Entity type:Individual
Prefix:
First Name:M REZA
Middle Name:
Last Name:RAJI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:REZA
Other - Middle Name:
Other - Last Name:RAJI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:104 RIDING TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-1538
Mailing Address - Country:US
Mailing Address - Phone:412-963-0294
Mailing Address - Fax:412-963-0294
Practice Address - Street 1:540 MAYER ST
Practice Address - Street 2:MEDICAL DEPT.
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2709
Practice Address - Country:US
Practice Address - Phone:412-257-7326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038918L2083P0500X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAD71176Medicare UPIN