Provider Demographics
NPI:1124044425
Name:SWAMY, RAJAKUMARI L (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJAKUMARI
Middle Name:L
Last Name:SWAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4065 E COOK RD
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8021
Mailing Address - Country:US
Mailing Address - Phone:810-695-2500
Mailing Address - Fax:810-695-6766
Practice Address - Street 1:4065 E COOK RD
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8021
Practice Address - Country:US
Practice Address - Phone:810-695-2500
Practice Address - Fax:810-695-6766
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS063241207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0005925576OtherAETNA
MI0980138OtherHEALTH PLUS
MI0250320OtherBCBS
1693920014OtherSELECTCARE
MI4266146Medicaid
MIC5216414OtherMCARE
G58746OtherHAP
MIC5216414OtherMCARE
G58746Medicare UPIN