Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 4301031717 | MI |
NPI | 1033439807 |
---|---|
Provider Name | S Raja Sekharan |
First Address | Bloomfield Hills, MI 48304-2347 |
Second Address | Bloomfield Hills, MI 48304-2347 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2010 |
Last Update Date | 03/06/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A77535 | (02) | MI |