Provider Demographics
NPI:1225180672
Name:SEMUR P. RAJAN, M.D., INC
Entity Type:Organization
Organization Name:SEMUR P. RAJAN, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEMUR
Authorized Official - Middle Name:P
Authorized Official - Last Name:RAJAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-756-1230
Mailing Address - Street 1:275 CLINE AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1019
Mailing Address - Country:US
Mailing Address - Phone:419-756-1230
Mailing Address - Fax:419-756-8654
Practice Address - Street 1:275 CLINE AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1019
Practice Address - Country:US
Practice Address - Phone:419-756-1230
Practice Address - Fax:419-756-8654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2009-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35033496R208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH302425177005OtherMEDICAL MUTUAL
OH733669OtherBUCKEYE COMMUNITY HEALTH
OH0166252Medicaid
OH000000389423OtherANTHEM BLUE CROSS
OH000000181984Medicaid
OH30242517700OtherWORKER'S COMP
OHDE5301OtherMEDICARE RAILROAD
OH=========026Medicaid
OH9360491Medicare ID - Type Unspecified
OH30242517700OtherWORKER'S COMP