Basic Information
Provider Information
NPI: 1831103860
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAJNIK
FirstName: MICHAEL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 613 PARK RIDGE DR
Address2:  
City: MOUNT AIRY
State: MD
PostalCode: 217712812
CountryCode: US
TelephoneNumber: 3012953391
FaxNumber: 3012953898
Practice Location
Address1: 6900 GEORGIA AVE NW
Address2:  
City: WASHINGTON
State: DC
PostalCode: 203070003
CountryCode: US
TelephoneNumber: 2027827250
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/27/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0208XMD-063659-LPAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases

No ID Information.


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