Most Relevant Information
Provider Data
| NPI Number: | 1003257130 |
| Provider Name: | RAJAGOPALAN RENGAN D.O |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | 25MB09747500 |
Most Important Dates
| Enumeration Date: | 07/17/2013 |
| Last Updated: | 12/04/2019 |
Provider Practice Location
3401 N BROAD ST
PHILADELPHIA
PA
191405103
Practice Location Phone/Fax
| Phone: | 2157078163 |
| Fax: |
Provider Mailing Location
502 KINGS DR
CHERRY HILL
NJ
080033012
Provider Mailing Phone/Fax
| Phone: | 7328218080 |
| Fax: |
Suggested EMR
Internist EMR