Individual
PAUL KODUVATH RAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 15TH ST NW, NORTON, VA 24273-1616
(276) 439-1000
Mailing address
6717 CROOKED STICK DR, FORT WORTH, TX 76132-4527
(817) 361-1810
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0116032605
VA
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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