Provider Demographics
NPI:1427154913
Name:KAIKAUS, RAJA M (MD)
Entity type:Individual
Prefix:
First Name:RAJA
Middle Name:M
Last Name:KAIKAUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40201-0909
Mailing Address - Country:US
Mailing Address - Phone:502-568-6616
Mailing Address - Fax:502-568-6614
Practice Address - Street 1:225 ABRAHAM FLEXNER WAY
Practice Address - Street 2:SUITE 402
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202
Practice Address - Country:US
Practice Address - Phone:502-568-6616
Practice Address - Fax:502-568-6614
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31769207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E91889Medicare UPIN
KYP01129725Medicare PIN
KYK066780Medicare Oscar/Certification