Individual
VIJAY RASTOGI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20050 HARVARD AVE, #304 CHARLES MINER BLDG, WARRENSVILLE HEIGHTS, OH 44122-6816
(216) 283-0750
(216) 491-6374
Mailing address
20050 HARVARD AVE, #304 CHARLES MINER BLDG, WARRENSVILLE HEIGHTS, OH 44122-6816
(216) 283-0750
(216) 491-6374
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
35-075697
OH
207R00000X
Internal Medicine Physician
35075697R
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2181697
—
OH
Enumeration date
09/20/2006
Last updated
09/21/2011
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