Provider Demographics
NPI:1497082697
Name:SEETHA RAMMOHAN, HARISH RAJ (MD,MRCP)
Entity Type:Individual
Prefix:DR
First Name:HARISH RAJ
Middle Name:
Last Name:SEETHA RAMMOHAN
Suffix:
Gender:M
Credentials:MD,MRCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1141 N MONROE DR FL 3
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-1619
Mailing Address - Country:US
Mailing Address - Phone:937-372-3638
Mailing Address - Fax:937-372-3642
Practice Address - Street 1:1141 N MONROE DR FL 3
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1619
Practice Address - Country:US
Practice Address - Phone:937-372-3638
Practice Address - Fax:937-372-3642
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-09
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY281738207RC0000X
OH35.134987207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0321310Medicaid