Individual
RAJU MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6525 POWERS BLVD, 301, PARMA, OH 44129-5461
(440) 882-0075
(440) 882-2092
Mailing address
6525 POWERS BLVD, 301, PARMA, OH 44129-5461
(440) 882-0075
(440) 882-2092
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
35074487
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130054
ANTHEM BC/BS
OH
01
—
060054639
RAILROAD MEDICARE
OH
05
—
2080206
—
OH
Enumeration date
06/06/2006
Last updated
01/15/2021
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