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NPI Code Detail

MEDICARE: DR. PAUL T RAJASEKHAR M.D.

MEDICARE: DR. PAUL T RAJASEKHAR M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician4301042407MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2PR042407OTHERMISTATE LICENSE NUMBER

General Provider Information

NPI Number : 1699801027
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL T RAJASEKHAR M.D.
Provider Business Mailing Address
First Line : 975 GOLF COURSE RD
Second Line :
City : ALPENA
State : MI
Zip : 49707-1115
Country : US
Telephone Number : 989-356-2161
Fax Number :
Provider Business Practice Location Address
First Line : 400 JOHNSON ST
Second Line :
City : ALPENA
State : MI
Zip : 49707-1434
Country : US
Telephone Number : 989-356-2161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/09/2007

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