Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | RR043376 | MI |
N | 207YP0228X | Pediatric Otolaryngology | RR043376 | MI |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | RR043376 | MI |
NPI | 1265406623 |
---|---|
Provider Name | Dr. Rajagopalan Rajaraman |
First Address | Taylor, MI 48180-6200 |
Second Address | Taylor, MI 48180-6200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 12/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2925008 | (05) | MI |
A79159 | (02) | MI |