MEDICARE: RAJANI V VALLABHANENI M.D.

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	207Q00000X	Family Medicine Physician	35.092341	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245434638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAJANI V VALLABHANENI M.D.

Provider Business Mailing Address
First Line	:	645 HARDWICK DR
Second Line	:
City	:	AURORA
State	:	OH
Zip	:	44202-7004
Country	:	US
Telephone Number	:	216-905-2202
Fax Number	:

Provider Business Practice Location Address
First Line	:	7225 OLD OAK BLVD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-3339
Country	:	US
Telephone Number	:	440-816-2761
Fax Number	:

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

Provider Enumeration Date	:	06/12/2007
Last Update Date	:	09/26/2023

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