Provider Demographics
NPI:1992864177
Name:MATHUR, RAJ PRATAP (MD)
Entity type:Individual
Prefix:DR
First Name:RAJ
Middle Name:PRATAP
Last Name:MATHUR
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 1:10218 YEARLING DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3548
Mailing Address - Country:US
Mailing Address - Phone:240-252-4008
Mailing Address - Fax:
Practice Address - Street 1:106 IRVING ST NW STE 211
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2993
Practice Address - Country:US
Practice Address - Phone:202-722-0149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054105207RG0300X
MDD0042403207RG0300X
DCMD19927207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0402333OtherUNITED HEALTHCARE
MD54357601OtherBCBS
522004721OtherALLIANCE PPO
68766OtherAMERIGROUP
7133432OtherAETNA PPO
DC40840001OtherBCBS
MD090902501Medicaid
DC010371400Medicaid
865068OtherMDIPA
DC2241948OtherAETNA DC
DC2241948OtherAETNA DC
MD090902501Medicaid
68766OtherAMERIGROUP
DC010371400Medicaid