Provider Demographics
NPI:1154828036
Name:KEDAR, ROHAN PRAVEEN (MD)
Entity Type:Individual
Prefix:
First Name:ROHAN
Middle Name:PRAVEEN
Last Name:KEDAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5958 N CANTON CENTER RD STE 900
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-2740
Mailing Address - Country:US
Mailing Address - Phone:734-737-1200
Mailing Address - Fax:734-737-1205
Practice Address - Street 1:5958 N CANTON CENTER RD STE 900
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-2740
Practice Address - Country:US
Practice Address - Phone:734-786-2300
Practice Address - Fax:734-786-4915
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-09
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43015033812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry