Healthcare Provider Details

I. General information

NPI: 1134334394
Provider Name (Legal Business Name): RAJESH BHAGAT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4020 S VERNOY
WAYNE MI
48184
US

IV. Provider business mailing address

4020 S VERNOY
WAYNE MI
48184
US

V. Phone/Fax

Practice location:
  • Phone: 734-722-6110
  • Fax: 734-729-6788
Mailing address:
  • Phone: 734-722-6110
  • Fax: 734-729-6788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberRB032966
License Number StateMI

VIII. Authorized Official

Name: DR. RAJESH BHAGAT
Title or Position: OWNER
Credential: MD
Phone: 734-722-6110