Provider Demographics
NPI:1003049065
Name:RAJ PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:RAJ PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOYESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-808-8030
Mailing Address - Street 1:30400 DETROIT RD STE LL10
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-5845
Mailing Address - Country:US
Mailing Address - Phone:440-808-8030
Mailing Address - Fax:440-808-8032
Practice Address - Street 1:30400 DETROIT RD STE LL10
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-5845
Practice Address - Country:US
Practice Address - Phone:440-808-8030
Practice Address - Fax:440-808-8032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-25
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3003789Medicaid
OH9386401Medicare PIN