Provider Demographics
NPI:1073833729
Name:VENKATESH, RAJITHA DEVADOSS (MD)
Entity Type:Individual
Prefix:
First Name:RAJITHA
Middle Name:DEVADOSS
Last Name:VENKATESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:RAJITHA
Other - Middle Name:
Other - Last Name:DEVADOSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:700 CHILDRENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43205-2664
Mailing Address - Country:US
Mailing Address - Phone:614-722-2000
Mailing Address - Fax:
Practice Address - Street 1:700 CHILDRENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205-2664
Practice Address - Country:US
Practice Address - Phone:614-722-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.139387208000000X, 2080P0206X, 2080P0206X
MABOARD ELIGIBLE2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0402207Medicaid
OHH722150OtherCGS - MEDICARE