Individual
RAKESH KHATRI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7910 W JEFFERSON BLVD STE 120, FORT WAYNE, IN 46804-4159
(260) 435-7612
(260) 479-4618
Mailing address
6920 POINTE INVERNESS WAY STE 200, FORT WAYNE, IN 46804-7934
(260) 479-3514
(260) 479-3520
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
R0043
TX
2084A2900X
Neurocritical Care Physician
R0043
TX
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
R0043
TX
2084N0400X
Neurology Physician
R0043
TX
2084V0102X
Vascular Neurology Physician
R0043
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201014070
—
IN
Enumeration date
05/25/2007
Last updated
11/27/2023
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