MEDICARE: MR. SEMUR PERUMAL RAJAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	35033496R	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000389423	OTHER	OH	ANTHEM BLUE CROSS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427041367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SEMUR PERUMAL RAJAN MD

Provider Business Mailing Address
First Line	:	275 CLINE AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-1019
Country	:	US
Telephone Number	:	419-756-1230
Fax Number	:	419-756-8654

Provider Business Practice Location Address
First Line	:	275 CLINE AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-1019
Country	:	US
Telephone Number	:	419-756-1230
Fax Number	:	419-756-8654

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	07/09/2007

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