Provider Demographics
NPI:1063520419
Name:SESHAN, RAJINIKANTH (MD)
Entity type:Individual
Prefix:
First Name:RAJINIKANTH
Middle Name:
Last Name:SESHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 UPPER RIVERDALE RD SW
Mailing Address - Street 2:SUITE B
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-4945
Mailing Address - Country:US
Mailing Address - Phone:216-533-8842
Mailing Address - Fax:
Practice Address - Street 1:253 UPPER RIVERDALE RD SW
Practice Address - Street 2:SUITE B
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-4945
Practice Address - Country:US
Practice Address - Phone:216-533-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA068790207RN0300X
OH35.087829207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003144035AMedicaid
GA003144035AMedicaid