Provider Demographics
NPI:1629652706
Name:SHEKHAR, RAJ (MD)
Entity type:Individual
Prefix:
First Name:RAJ
Middle Name:
Last Name:SHEKHAR
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:EAST MOUNTAIN MEDICAL RURAL HEALTH CLINIC
Mailing Address - Street 2:780 S MAIN STREET
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230
Mailing Address - Country:US
Mailing Address - Phone:413-854-9753
Mailing Address - Fax:413-528-2907
Practice Address - Street 1:EAST MOUNTAIN MEDICAL RURAL HEALTH CLINIC
Practice Address - Street 2:780 S MAIN STREET
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230
Practice Address - Country:US
Practice Address - Phone:413-854-9753
Practice Address - Fax:413-528-2907
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2025-03-26
Deactivation Date:2022-05-06
Deactivation Code:
Reactivation Date:2022-07-18
Provider Licenses
StateLicense IDTaxonomies
MA1020477207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine