Provider Demographics
NPI:1912695545
Name:UDAI J RABBAN PLLC
Entity Type:Organization
Organization Name:UDAI J RABBAN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-814-3337
Mailing Address - Street 1:1451 CEDARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-1875
Mailing Address - Country:US
Mailing Address - Phone:810-659-7592
Mailing Address - Fax:810-659-7202
Practice Address - Street 1:5130 COOLIDGE HWY # 120
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-1001
Practice Address - Country:US
Practice Address - Phone:248-658-0878
Practice Address - Fax:248-435-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty