Provider Demographics
NPI:1740347566
Name:KANERIA, RAKESHKUMAR (MD)
Entity type:Individual
Prefix:
First Name:RAKESHKUMAR
Middle Name:
Last Name:KANERIA
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 635924
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5924
Mailing Address - Country:US
Mailing Address - Phone:513-217-5221
Mailing Address - Fax:513-217-6221
Practice Address - Street 1:7760 WEST VOA PARK DR
Practice Address - Street 2:SUITE G
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-3371
Practice Address - Country:US
Practice Address - Phone:513-217-5221
Practice Address - Fax:513-217-6221
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350834402084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2504678Medicaid
OH293747OtherAMERIGROUP
OH9178122OtherAETNA BEHAVIORAL
OH000000547707OtherANTHEM
I13020Medicare UPIN
OHKA4139301Medicare PIN
OH293747OtherAMERIGROUP