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General NPI Number Information
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NPI Number | 1174659619
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Entity Type | Individual
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Provider Name | MR. RAJ DUSHYANT KANERIA
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Gender | Male
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 1225 S LATSON RD STE 100
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City | HOWELL
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State | MI
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Zip | 48843-7658
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Country | US
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Telephone | 734-663-1362
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Fax | 734-663-0445
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Provider Business Mailing Address
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Address Line | 47823 JAKE LN
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City | CANTON
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State | MI
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Zip | 48187-5837
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Country | US
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Telephone | 734-983-0317
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Fax | 734-663-0445
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302031380
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License Number State | MI
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