Individual
RAJ SHIVAJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1225 GRAHAM RD, FLORISSANT, MO 63031-8014
(314) 953-6000
Mailing address
75 REMIT DRIVE, LOCKBOX 6804, CHICAGO, IL 60675-6804
(866) 916-5259
(231) 922-4030
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036-097085
IL
207P00000X
Emergency Medicine Physician
111366
MO
207P00000X
Emergency Medicine Physician
62808
NJ
207R00000X
Internal Medicine Physician
Primary
T4849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204666937
—
MO
Enumeration date
07/13/2006
Last updated
09/27/2022
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