Individual
GURSHARN SINGH RAKHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11803 JEFFERSON AVE STE 230, NEWPORT NEWS, VA 23606-4390
(757) 534-7701
(757) 534-7708
Mailing address
11803 JEFFERSON AVE STE 230, NEWPORT NEWS, VA 23606-4390
(757) 534-7701
(757) 534-7708
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
0101242788
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100014797
RR MEDICARE PIN
KY
01
—
37903705
MEDICAID LAB GROUP
KY
01
—
4000501
MEDICARE LAB GROUP
KY
05
—
64018070
—
KY
01
—
CB5773
RR MEDICARE GROUP
KY
Enumeration date
07/12/2006
Last updated
04/13/2011
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