Provider Demographics
NPI:1245438308
Name:D RAHEJA MD INC
Entity type:Organization
Organization Name:D RAHEJA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-823-1515
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44236-0465
Mailing Address - Country:US
Mailing Address - Phone:440-823-1515
Mailing Address - Fax:330-656-2468
Practice Address - Street 1:2307 W 14TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113-3612
Practice Address - Country:US
Practice Address - Phone:216-687-4044
Practice Address - Fax:216-687-4074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350654082084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2796283Medicaid
OH9369671Medicare PIN