Provider Demographics
NPI:1285603498
Name:AYASH, RAJA E (MD)
Entity type:Individual
Prefix:DR
First Name:RAJA
Middle Name:E
Last Name:AYASH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 REDLAND CT
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-3290
Mailing Address - Country:US
Mailing Address - Phone:410-494-7921
Mailing Address - Fax:410-902-8247
Practice Address - Street 1:3333 N CALVERT ST
Practice Address - Street 2:SUITE 650
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2867
Practice Address - Country:US
Practice Address - Phone:410-467-4470
Practice Address - Fax:410-467-4877
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020111207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD382591400Medicaid
MDK53130SSOtherMEDICARE PTAN
MDK53130SSOtherMEDICARE PTAN