Individual ProviderThevarajani RajakumarPediatricsAllopathic & Osteopathic PhysiciansPractice Address664 Lincoln St, Portsmouth, VA 23704-4818(757) 393-6363PECOS EnrollmentBased on the most recent information from CMS, provider Thevarajani Rajakumar is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1790701811Provider TypeIndividualFull NameRajakumar, ThevarajaniCredentialMDGenderFemaleSole ProprietorNoEnumeration Date7/14/2006Last Updated12/21/2010Contact InformationPractice LocationPractice Address664 Lincoln St, Portsmouth, VA 23704-4818Phone(757) 393-6363Fax(757) 393-1336Mailing LocationMailing Address664 Lincoln St, Portsmouth, VA 23704-4818Phone(757) 393-6363Fax(757) 393-1336Provider TaxonomiesCodeDescriptionLicenseCode208000000XPrimaryDescriptionPediatricsAllopathic & Osteopathic PhysiciansLicense0101240271VirginiaProvider IdentifiersIDDescriptionIssuerID5904574DescriptionMedicaidIssuerUnlistedNorth Carolina