Provider Demographics
NPI:1801863998
Name:MEDICAL MANAGEMENT PC
Entity Type:Organization
Organization Name:MEDICAL MANAGEMENT PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJNIKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:NAGARSHETH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-831-5913
Mailing Address - Street 1:430 MACK AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201-2136
Mailing Address - Country:US
Mailing Address - Phone:313-831-5913
Mailing Address - Fax:313-831-5991
Practice Address - Street 1:430 MACK AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2136
Practice Address - Country:US
Practice Address - Phone:313-831-5913
Practice Address - Fax:313-831-5991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N85870OtherMEDICARE GROUP #
MI0H22035OtherBCBSM GROUP #