Provider Demographics
NPI:1861577629
Name:VYAS, RAJESH (MD)
Entity type:Individual
Prefix:MR
First Name:RAJESH
Middle Name:
Last Name:VYAS
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 1:2511 SAINT CHARLES AVE
Mailing Address - Street 2:# 505
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5956
Mailing Address - Country:US
Mailing Address - Phone:504-897-5499
Mailing Address - Fax:
Practice Address - Street 1:AMERICAN EMBASSY
Practice Address - Street 2:HEALTH UNIT, DIPLOMATIC ENCLAVE, RAMNA-5
Practice Address - City:ISLAMABAD
Practice Address - State:CAPITAL
Practice Address - Zip Code:4400
Practice Address - Country:PK
Practice Address - Phone:0119251-208-0000
Practice Address - Fax:208-2473
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY33154207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64331549Medicaid
KYG62155Medicare UPIN