Provider Demographics
NPI:1083613129
Name:RAJARATNAM, SHANTHI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANTHI
Middle Name:
Last Name:RAJARATNAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013-1077
Mailing Address - Country:US
Mailing Address - Phone:513-867-9000
Mailing Address - Fax:513-785-3675
Practice Address - Street 1:1391 MAIN ST
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-1077
Practice Address - Country:US
Practice Address - Phone:513-867-9000
Practice Address - Fax:513-785-3675
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069981R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2029469Medicaid
OHRA0820123Medicare PIN
OH2029469Medicaid