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Individual

DR. ARCHANA RASTOGI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
5107 MOORES MILL RD, HUNTSVILLE, AL 35811-1007
(256) 851-7190
(256) 851-7189
Mailing address
7583 WALL TRIANA HWY, MADISON, AL 35757-8327
(256) 830-5777
(256) 546-2981

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00021023
AL
207R00000X
Internal Medicine Physician
00021023
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009942017
AL
01
051558657
MEDICARE
AL
01
51005125
BLUE CROSS BLUE SHIELD
AL
01
51005127
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/18/2005
Last updated
03/23/2015
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