1861580441 NPI number — RAJ S KASTHURI MBBS, MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861580441 NPI number — RAJ S KASTHURI MBBS, MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KASTHURI

Provider First Name:

RAJ

Provider Middle Name:

S

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MBBS, MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1861580441

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/01/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

UNIVERITY OF NORTH CAROLINA

Provider Second Line Business Mailing Address:

CB7035, 1047 GENETIC MEDICINE BLDG, 120 MASON FARM RD

Provider Business Mailing Address City Name:

CHAPEL HILL

Provider Business Mailing Address State Name:

NC

Provider Business Mailing Address Postal Code:

27599-0001

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

919-966-3311

Provider Business Mailing Address Fax Number:

919-843-4896

Provider First Line Business Practice Location Address:

UNIVERSITY OF NORTH CAROLINA HOSPITALS

Provider Second Line Business Practice Location Address:

101 MANNING DRIVE

Provider Business Practice Location Address City Name:

CHAPEL HILL

Provider Business Practice Location Address State Name:

NC

Provider Business Practice Location Address Postal Code:

27599-0001

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

919-966-3311

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

10/10/2006

Authorized Official Last Name:

Authorized Official First Name:

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Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207R00000X , with the licence number:  44740 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207RH0000X , with the licence number: 2007-01374 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1044848 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 36-00611 . This is a "MEDICA-CHOICE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 34802800 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
• Identifier: 499368 . This is a "FAIRVIEW" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 135164 . This is a "U CARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: 36-00013 . This is a "MEDICA-PRIMARY" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: B619 . This is a "CHAMPUS" identifier . This identifiers is of the category "OTHER".
• Identifier: 0147747 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
• Identifier: 2378190 . This is a "ARAZ" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
• Identifier: P00282875 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: HP55120 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".