Provider Demographics
NPI:1134334394
Name:RAJESH BHAGAT MD PC
Entity type:Organization
Organization Name:RAJESH BHAGAT MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAGAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-722-6110
Mailing Address - Street 1:4020 S VERNOY
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184
Mailing Address - Country:US
Mailing Address - Phone:734-722-6110
Mailing Address - Fax:734-729-6788
Practice Address - Street 1:4020 S VERNOY
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:MI
Practice Address - Zip Code:48184
Practice Address - Country:US
Practice Address - Phone:734-722-6110
Practice Address - Fax:734-729-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRB0329662086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0205005432OtherBCN
MIA9467OtherMCARE
MI505286OtherCARE CHOICES
MI9143010Medicaid
MI7430495OtherAETNA
MI1104390001OtherWELLNESS GROUP
MI0205005432OtherBCBS
MID90152OtherHAP
MIM023954OtherCHAMPUS
MI5404AOtherCAPE HEALTH PLAN
MID90152OtherHAP
MIM023954OtherCHAMPUS
MI05005434021Medicare ID - Type Unspecified