Provider Demographics
NPI:1609853811
Name:RAJAH, VASANTHY (MD)
Entity Type:Individual
Prefix:
First Name:VASANTHY
Middle Name:
Last Name:RAJAH
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 1:101 COMMERCE PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-8349
Mailing Address - Country:US
Mailing Address - Phone:614-898-3006
Mailing Address - Fax:614-898-3023
Practice Address - Street 1:101 COMMERCE PARK DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-8349
Practice Address - Country:US
Practice Address - Phone:614-898-3006
Practice Address - Fax:614-898-3023
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-7671207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0234919Medicaid
OH0234919Medicaid
OHF93272Medicare UPIN