Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301109078 | MI |
Y | 2080P0205X | Pediatric Endocrinologist | 4301109078 | MI |
NPI | 1326484544 |
---|---|
Provider Name | Rajeev Thirunagari |
First Address | Detroit, MI 48201 |
Second Address | Detroit, MI 48201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2013 |
Last Update Date | 20/08/2016 |