MEDICARE: SEMUR P. RAJAN, M.D., INC

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

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	DE5301	OTHER	OH	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	302425177005	OTHER	OH	MEDICAL MUTUAL
2	733669	OTHER	OH	BUCKEYE COMMUNITY HEALTH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000389423	OTHER	OH	ANTHEM BLUE CROSS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	30242517700	OTHER	OH	WORKER'S COMP

General Provider Information

NPI Number	:	1225180672
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEMUR P. RAJAN, M.D., INC

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	:	PRESIDENT
Name	:	DR. SEMUR P. RAJAN
Credential	:	M.D.
Telephone Number	:	419-756-1230

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	12/03/2009

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