Kadam, Rajesh Shivaji
Kadam, Rajesh Shivaji is an sole proprietor health care provider with primary practice located at 403 N State Of Franklin Rd , Johnson City TN 37604-6034. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Kadam, Rajesh Shivaji can be contacted via phone (423) 431-7047.Contact Information
Primary practice address
403 N State Of Franklin Rd
Johnson City TN 37604-6034
Phone: (423) 431-7047
Fax: (423) 979-0569
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207RA0000X | 517 | Tennessee |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 517 | Tennessee |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 42576 | Tennessee |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 0101241538 | Virginia |
Profile Details
| NPI number | 1134336563 |
|---|---|
| LBN Legal business name | Kadam, Rajesh Shivaji |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 16th, 2007 |
| Last updated | Feb 13th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134336563 | NPPES |
| Tennessee | MEDICAID | 1504642 | |
| Tennessee | MEDICAID | 1134336563 | |
| Tennessee | MEDICAID | 3001511 |
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