Provider Demographics
NPI:1396923793
Name:SWAMY, RAJIV SETH (MD)
Entity type:Individual
Prefix:
First Name:RAJIV
Middle Name:SETH
Last Name:SWAMY
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 1:709 WICKER ST STE A
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-4168
Mailing Address - Country:US
Mailing Address - Phone:919-774-6262
Mailing Address - Fax:919-774-1952
Practice Address - Street 1:709 WICKER ST STE A
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-4168
Practice Address - Country:US
Practice Address - Phone:919-774-6262
Practice Address - Fax:919-774-1952
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD446464207RI0011X, 207RC0000X
NC2018-02197207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1396923793Medicaid
WV3810023927Medicaid
OH0070329Medicaid
PA1027542900001Medicaid
OH0070329Medicaid