Provider Demographics
NPI:1790778363
Name:RAKESH N SAXENA MD PC
Entity Type:Organization
Organization Name:RAKESH N SAXENA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAKESH
Authorized Official - Middle Name:N
Authorized Official - Last Name:SAXENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:989-463-4976
Mailing Address - Street 1:311 E WARWICK DR
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1013
Mailing Address - Country:US
Mailing Address - Phone:989-463-4976
Mailing Address - Fax:989-463-2249
Practice Address - Street 1:311 E WARWICK DR
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1013
Practice Address - Country:US
Practice Address - Phone:989-463-4976
Practice Address - Fax:989-463-2249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4310032524 (ACTIVE)207RG0100X
KS0419873 (INACTIVE)207RG0100X
NM82307 (INACTIVE LIC)207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0400990OtherPHYSICIANS HEALTH PLAN
MI1102943802OtherBLUE CROSS/BLUE SHIELD
MI09497AOtherMID MI HEALTH
MI1071464Medicaid
1102058586OtherRAILROAD MEDICARE
M002396OtherTRICARE
MI1005137OtherMCLAREN
MI09497AOtherMID MI HEALTH
MI1102943802OtherBLUE CROSS/BLUE SHIELD