Provider Demographics
NPI:1730149790
Name:RAJOO, SHARI K (MD)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:K
Last Name:RAJOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2204 PAVILION DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4657
Mailing Address - Country:US
Mailing Address - Phone:423-224-3900
Mailing Address - Fax:423-224-3901
Practice Address - Street 1:2204 PAVILION DR
Practice Address - Street 2:SUITE 310
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4657
Practice Address - Country:US
Practice Address - Phone:423-224-3900
Practice Address - Fax:423-224-3901
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2017-02-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN42149207Q00000X
NY233784207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1505112Medicaid
VA1730149790Medicaid
TN30003471Medicare PIN
NYI18062Medicare UPIN