Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | 079788 | MI |
NPI | 1154377646 |
---|---|
Provider Name | Raj Sekhon |
First Address | Ann Arbor, MI 48105-1598 |
Second Address | Wyandotte, MI 48192-4668 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 05/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4418702 | (05) | MI |
G34824 | (02) | MI |
RS079788 | BC/BS (01) | MI |