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NPI Code Detail

MEDICARE: RAJU MODI M.D.

MEDICARE: RAJU MODI 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
1207RC0000XCardiovascular Disease Physician35074487OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2060054639OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000130054OTHEROHANTHEM BC/BS

General Provider Information

NPI Number : 1528007143
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAJU MODI M.D.
Provider Business Mailing Address
First Line : 6525 POWERS BLVD
Second Line : 301
City : PARMA
State : OH
Zip : 44129-5461
Country : US
Telephone Number : 440-882-0075
Fax Number : 440-882-2092
Provider Business Practice Location Address
First Line : 6525 POWERS BLVD
Second Line : 301
City : PARMA
State : OH
Zip : 44129-5461
Country : US
Telephone Number : 440-882-0075
Fax Number : 440-882-2092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 01/15/2021

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Directions to “ RAJU MODI M.D.” Practice Location

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