Provider Demographics
NPI:1578561775
Name:RAJSHEKER, KOLLIPARA (MD)
Entity Type:Individual
Prefix:DR
First Name:KOLLIPARA
Middle Name:
Last Name:RAJSHEKER
Suffix:
Gender:M
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:PO BOX 932759
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44193-0015
Mailing Address - Country:US
Mailing Address - Phone:866-282-7905
Mailing Address - Fax:800-731-0751
Practice Address - Street 1:835 SWEITZER ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1007
Practice Address - Country:US
Practice Address - Phone:937-547-5723
Practice Address - Fax:937-547-5784
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045067207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH050081069OtherRAILROAD MEDICARE
IN200412160OtherINDIANA MEDICAID
OH2002255Medicaid