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General NPI Number Information
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NPI Number | 1144404062
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Entity Type | Organization
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Legal Business Name | RAJ SEETHARAMAN MD
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 767 BROADWAY AVE
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City | BEDFORD
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State | OH
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Zip | 44146-3644
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Country | US
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Telephone | 330-392-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 32280 WINTERGREEN DR
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City | SOLON
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State | OH
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Zip | 44139-1356
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PATABI SEETHARAMAN
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Credential | M.D.
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Telephone | 330-392-4100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 35057803
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License Number State | OH
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