Healthcare Provider Details

I. General information

NPI: 1194718692
Provider Name (Legal Business Name): NEERAJ MAHAJAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5133 RIDGE RD STE 5
WADSWORTH OH
44281-8078
US

IV. Provider business mailing address

24701 EUCLID AVE
EUCLID OH
44117-1714
US

V. Phone/Fax

Practice location:
  • Phone: 330-239-7250
  • Fax: 330-239-7251
Mailing address:
  • Phone: 330-239-7250
  • Fax: 330-239-7251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number23780
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number2008-01240
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35-097835
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: