Provider Demographics
NPI:1427052976
Name:RAJIAH, SAM EMERSON (MD)
Entity type:Individual
Prefix:DR
First Name:SAM
Middle Name:EMERSON
Last Name:RAJIAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3918 CLOCK POINTE TRL
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2989
Mailing Address - Country:US
Mailing Address - Phone:330-923-7300
Mailing Address - Fax:330-923-7301
Practice Address - Street 1:3918 CLOCK POINTE TRL
Practice Address - Street 2:SUITE 102
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2989
Practice Address - Country:US
Practice Address - Phone:330-923-7300
Practice Address - Fax:330-923-7301
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0357242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0226188Medicaid
OHA75149Medicare UPIN
OHRA0407642Medicare ID - Type Unspecified