Individual
YATHAVAN RAJAKULASINGAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
877 W FARIS RD, GREENVILLE, SC 29605-4289
(864) 455-7800
(864) 455-9082
Mailing address
300 E MCBEE AVE, GREENVILLE, SC 29601-2842
(864) 797-6306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
51389
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
513894
—
SC
Enumeration date
07/13/2017
Last updated
05/14/2021
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