Provider Demographics
NPI:1316190689
Name:BADGAIYAN, RAJENDRA D (MD)
Entity type:Individual
Prefix:DR
First Name:RAJENDRA
Middle Name:D
Last Name:BADGAIYAN
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 1:2301 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5829
Mailing Address - Country:US
Mailing Address - Phone:326-201-1604
Mailing Address - Fax:
Practice Address - Street 1:2301 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5829
Practice Address - Country:US
Practice Address - Phone:326-201-1604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2024-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA103973002084P0800X
NY2554962084P0800X
MA2205012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry