Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | RM043153 | MI |
NPI | 1134192560 |
---|---|
Provider Name | Raka Mahajan |
First Address | Dearborn, MI 48124-2598 |
Second Address | Dearborn, MI 48124-2598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 18/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000003118 | CAPE HEALTH (01) | MI |
019394 | MIDWEST HEALTH (01) | MI |
110167981 | TRAVELERS MEDICARE (01) | MN |
1108224641 | BLUE CROSS BLUE SHIELD (01) | MI |
1566855 | (05) | MI |
B45910 | (02) | MI |
C3278 | MCARE (01) | MI |