Provider Demographics
NPI:1851358527
Name:RAJPUT, MANZAR YOUSUF (MD)
Entity Type:Individual
Prefix:DR
First Name:MANZAR
Middle Name:YOUSUF
Last Name:RAJPUT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1 SEAGATE STE 800
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-1558
Mailing Address - Country:US
Mailing Address - Phone:734-240-1760
Mailing Address - Fax:734-240-1763
Practice Address - Street 1:718 N MACOMB ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162
Practice Address - Country:US
Practice Address - Phone:734-240-1760
Practice Address - Fax:734-240-1763
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010737272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104166991Medicaid
MI260043230OtherRR MEDICARE