Basic Information
| Provider Information | |||||||||
| NPI: | 1811929144 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GADH | ||||||||
| FirstName: | RAJDEEP | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 722 RIVERSIDE DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330717008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543454333 | ||||||||
| FaxNumber: | 9543454334 | ||||||||
| Practice Location | |||||||||
| Address1: | 722 RIVERSIDE DR | ||||||||
| Address2: | |||||||||
| City: | CORAL SPRINGS | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330717008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9543454333 | ||||||||
| FaxNumber: | 9543454334 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 05/13/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | ME91441 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 273495800 | 05 | FL | MEDICAID |