Provider Demographics
| NPI: | 1629245568 |
|---|---|
| Name: | RAJ & ASSOCIATES M.D. P.C |
| Entity type: | Organization |
| Organization Name: | RAJ & ASSOCIATES M.D. P.C |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | PRAKASH |
| Authorized Official - Middle Name: | B |
| Authorized Official - Last Name: | GANDHI |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 248-827-7200 |
| Mailing Address - Street 1: | 26222 TELEGRAPH RD |
| Mailing Address - Street 2: | SUITE 100 |
| Mailing Address - City: | SOUTHFIELD |
| Mailing Address - State: | MI |
| Mailing Address - Zip Code: | 48033-5318 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 248-827-7200 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 26222 TELEGRAPH RD |
| Practice Address - Street 2: | SUITE 100 |
| Practice Address - City: | SOUTHFIELD |
| Practice Address - State: | MI |
| Practice Address - Zip Code: | 48033-5318 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 248-827-7200 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2008-05-09 |
| Last Update Date: | 2013-09-26 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 207U00000X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Group - Multi-Specialty | |
| No | 2085B0100X | Allopathic & Osteopathic Physicians | Radiology | Body Imaging | Group - Multi-Specialty |
| No | 2085N0700X | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | Group - Multi-Specialty |
| No | 2085N0904X | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | Group - Multi-Specialty |
| No | 2085R0204X | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | Group - Multi-Specialty |
| No | 2085U0001X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Ultrasound | Group - Multi-Specialty |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RA0401X | Allopathic & Osteopathic Physicians | Internal Medicine | Addiction Medicine | Group - Multi-Specialty |
| No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2081N0008X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Neuromuscular Medicine | Group - Multi-Specialty |
| No | 208D00000X | Allopathic & Osteopathic Physicians | General Practice | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MI | 0F36376 | Other | BCBS |
| MI | 0F36376 | Medicare PIN |