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General NPI Number Information
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NPI Number | 1689651143
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Entity Type | Individual
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Provider Name | MICHAEL J RAJKUMAR MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 112 LAFAYETTE ST
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City | NORWICH
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State | CT
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Zip | 06360-2737
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Country | US
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Telephone | 860-886-8545
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Fax | 855-629-7856
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Provider Business Mailing Address
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Address Line | 112 LAFAYETTE ST
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City | NORWICH
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State | CT
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Zip | 06360-2737
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Country | US
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Telephone | 860-886-8545
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Fax | 855-629-7856
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 038660
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License Number State | CT
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