Provider Demographics
NPI:1346667219
Name:RAJA, SUMRINE SHAMSHER (MD)
Entity Type:Individual
Prefix:MISS
First Name:SUMRINE
Middle Name:SHAMSHER
Last Name:RAJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2300 BIDDLE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-4650
Mailing Address - Country:US
Mailing Address - Phone:734-246-5705
Mailing Address - Fax:734-246-5750
Practice Address - Street 1:2300 BIDDLE AVE STE 100
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-4650
Practice Address - Country:US
Practice Address - Phone:734-246-5705
Practice Address - Fax:734-246-5750
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35138544207R00000X
MI4301117261207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine