Provider Demographics
NPI:1902856677
Name:IYER, RAJESH V (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:V
Last Name:IYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAJESH
Other - Middle Name:
Other - Last Name:VISWANATHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30701 BARRINGTON
Mailing Address - Street 2:SUITE 150 LMT CORPORATE OFFICE
Mailing Address - City:MADISON HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48071
Mailing Address - Country:US
Mailing Address - Phone:248-616-1170
Mailing Address - Fax:248-589-9875
Practice Address - Street 1:3535 W 13 MILE RD
Practice Address - Street 2:#437
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073
Practice Address - Country:US
Practice Address - Phone:248-288-2210
Practice Address - Fax:248-280-0505
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH85980208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
85980OtherOHIO
85980OtherOHIO
OHI44159771Medicare ID - Type Unspecified