Individual
TUSHAR JITENDRA VACHHARAJANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
023911
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10389844
—
VA
01
—
143GW
BCBS
—
05
—
1572110
—
LA
01
—
191659
MEDCOST
—
05
—
3810007243
—
WV
05
—
5905800
—
NC
01
—
782081
AETNA
—
01
—
808444
PARTNERS
—
Enumeration date
07/18/2006
Last updated
05/23/2008
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