Provider Demographics
NPI:1053849638
Name:RAJESHWARAN, ANCHELA (MD)
Entity type:Individual
Prefix:
First Name:ANCHELA
Middle Name:
Last Name:RAJESHWARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4777 E GALBRAITH ROAD
Mailing Address - Street 2:INTERNAL MEDICINE DEPARTMENT, GME OFFICE
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236
Mailing Address - Country:US
Mailing Address - Phone:513-686-5441
Mailing Address - Fax:513-686-5443
Practice Address - Street 1:593 EDDY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02903-4923
Practice Address - Country:US
Practice Address - Phone:513-686-5441
Practice Address - Fax:513-686-5443
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
RIMD17808208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMD17808OtherLICENSE