Provider Demographics
NPI:1093007718
Name:MACHANA, RAJA SEKHAR
Entity Type:Individual
Prefix:MR
First Name:RAJA
Middle Name:SEKHAR
Last Name:MACHANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15105 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-3719
Mailing Address - Country:US
Mailing Address - Phone:216-451-6260
Mailing Address - Fax:216-451-7303
Practice Address - Street 1:15105 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-3719
Practice Address - Country:US
Practice Address - Phone:216-451-6260
Practice Address - Fax:216-451-7303
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03329191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist