Provider Demographics
NPI:1760468953
Name:RAYA, NEELKANT (MD)
Entity Type:Individual
Prefix:DR
First Name:NEELKANT
Middle Name:
Last Name:RAYA
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 1:7643 LAURELWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8837
Mailing Address - Country:US
Mailing Address - Phone:740-654-6596
Mailing Address - Fax:740-653-2791
Practice Address - Street 1:1203 RIVER VALLEY BLVD
Practice Address - Street 2:SUITE-A
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1662
Practice Address - Country:US
Practice Address - Phone:740-654-6596
Practice Address - Fax:740-653-2791
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35069586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0224359Medicaid
OH$$$$$$$$$00OtherBWC
OHG20362Medicare UPIN
OH0224359Medicaid
OH110171617Medicare PIN