Provider Demographics
NPI:1104912773
Name:SELVARAJAH, RAMALINGAM (MD INC)
Entity type:Individual
Prefix:
First Name:RAMALINGAM
Middle Name:
Last Name:SELVARAJAH
Suffix:
Gender:M
Credentials:MD INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1161
Mailing Address - Country:US
Mailing Address - Phone:740-845-5500
Mailing Address - Fax:740-845-5502
Practice Address - Street 1:194 ELM ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1161
Practice Address - Country:US
Practice Address - Phone:740-845-5500
Practice Address - Fax:740-845-5502
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35074317S207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2064420Medicaid
OHP00018116OtherRAILROAD MEDICARE
OHP00018116OtherRAILROAD MEDICARE
OH4101481Medicare PIN