Provider Demographics
NPI:1316127319
Name:YALAMANCHILI, RAJ (MD)
Entity type:Individual
Prefix:DR
First Name:RAJ
Middle Name:
Last Name:YALAMANCHILI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:510 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 417
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4328
Mailing Address - Country:US
Mailing Address - Phone:443-643-3130
Mailing Address - Fax:443-643-3133
Practice Address - Street 1:510 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 417
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4328
Practice Address - Country:US
Practice Address - Phone:443-643-3130
Practice Address - Fax:443-643-3133
Is Sole Proprietor?:No
Enumeration Date:2007-11-07
Last Update Date:2013-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0072029207XS0114X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD043958400Medicaid
MD043958400Medicaid