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Individual

DR. KAVITA RAJ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
1399 N BALDWIN AVENUE, MARION, IN 46952-7550
(765) 660-7550
(765) 662-4467
Mailing address
330 N WABASH AVE STE G-20, MARION, IN 46952-2605
(765) 660-7600
(765) 651-7313

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001903
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000763629
ANTHEM
IN
05
200170890
IN
Enumeration date
11/30/2005
Last updated
10/19/2020
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