Basic Information
Provider Information
NPI: 1164681607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAKHUJA
FirstName: RAHUL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 105 W STONE DR
Address2: SUITE 6A
City: KINGSPORT
State: TN
PostalCode: 376603365
CountryCode: US
TelephoneNumber: 4234087220
FaxNumber: 4234087405
Practice Location
Address1: 2050 MEADOWVIEW PARKWAY
Address2:  
City: KINGSPORT
State: TN
PostalCode: 376607332
CountryCode: US
TelephoneNumber: 4232305000
FaxNumber: 4232305097
Other Information
ProviderEnumerationDate: 06/09/2008
LastUpdateDate: 12/03/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XP-224886MAN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RI0011X46709TNY Allopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
207RC0000X46709TNN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207R00000X46709TNN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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