Healthcare Provider Details

I. General information

NPI: 1174659619
Provider Name (Legal Business Name): MR. RAJ DUSHYANT KANERIA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RAJ DUSHYANT PATEL

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 S LATSON RD STE 100
HOWELL MI
48843-7658
US

IV. Provider business mailing address

47823 JAKE LN
CANTON MI
48187-5837
US

V. Phone/Fax

Practice location:
  • Phone: 734-663-1362
  • Fax: 734-663-0445
Mailing address:
  • Phone: 734-983-0317
  • Fax: 734-663-0445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302031380
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: