Organization
KHOZEMA RAJKOTWALA MD INC
Active
Other names
PRIMARY FAMILY HEALTHCARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHOZEMA M RAJKOTWALA MD (MD SELFEMPLOYED)
(740) 375-0775
Entity
Organization
Contact information
Practice address
990 SOUTH PROSPECT STREET, SUITE 2, MARION, OH 43302
(740) 375-0775
(740) 375-0774
Mailing address
990 SOUTH PROSPECT STREET, SUITE 2, MARION, OH 43302
(740) 375-0775
(740) 375-0774
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
350677778
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141025
ANTHEM
OH
05
—
0176321
—
OH
01
—
0404230
UHC
—
01
—
110183567
RR MEDICARE
—
Enumeration date
08/21/2006
Last updated
04/01/2014
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