Provider Demographics
NPI:1316964125
Name:DHAMECHA, RAJESH D (MD)
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:D
Last Name:DHAMECHA
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 1:9998 CROSSPOINT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-3307
Mailing Address - Country:US
Mailing Address - Phone:317-579-2150
Mailing Address - Fax:317-579-2130
Practice Address - Street 1:9998 CROSSPOINT BLVD STE 200
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-3307
Practice Address - Country:US
Practice Address - Phone:317-579-2150
Practice Address - Fax:317-579-2130
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01049025A2085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100055650AMedicaid
152520QQMedicare PIN
INH73245Medicare UPIN
151670MMMedicare PIN
152380RRMedicare PIN
160120KKMedicare PIN
151520GGMedicare PIN
15160KKMedicare PIN
222750CCMedicare PIN
151720KKMedicare PIN
150900CCMedicare PIN
151540GGMedicare PIN
IN824400IIMedicare UPIN
152690FFMedicare PIN
IN100055650AMedicaid
151700AAAMedicare PIN
152410RRMedicare PIN
152460LLMedicare PIN
228050LLMedicare PIN
151530EEMedicare PIN