Provider Demographics
NPI:1386086569
Name:MAKADIA, RAJ (MD)
Entity type:Individual
Prefix:
First Name:RAJ
Middle Name:
Last Name:MAKADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:2929 E THOMAS RD
Mailing Address - Street 2:FAMILY MEDICINE
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-8034
Mailing Address - Country:US
Mailing Address - Phone:602-470-5043
Mailing Address - Fax:602-470-5064
Practice Address - Street 1:12428 W THUNDERBIRD RD
Practice Address - Street 2:FAMILY MEDICINE
Practice Address - City:EL MIRAGE
Practice Address - State:AZ
Practice Address - Zip Code:85335-3113
Practice Address - Country:US
Practice Address - Phone:623-344-6500
Practice Address - Fax:623-344-6501
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-29
Last Update Date:2016-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ51596207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program