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General NPI Number Information
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NPI Number | 1760626436
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Entity Type | Individual
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Provider Name | VISWANATHAN RAJAGOPALAN M.B.B.S
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Gender | Male
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 14290 KNOLSON ST
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City | LIVONIA
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State | MI
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Zip | 48154-4759
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Country | US
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Telephone | 914-563-2729
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Fax |
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Provider Business Mailing Address
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Address Line | 14290 KNOLSON ST
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City | LIVONIA
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State | MI
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Zip | 48154-4759
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Country | US
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Telephone | 914-563-2729
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Fax |
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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 | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD2017-0836
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 254620
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD417803
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License Number State | PA
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Taxonomy #4
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 4301510983
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | 01079763A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD2017-0836
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License Number State | NM
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Taxonomy #7
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 254620
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License Number State | NY
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Taxonomy #8
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD417803
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License Number State | PA
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Taxonomy #9
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 4301510983
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 01079763A
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License Number State | IN
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Taxonomy #11
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 4301510983
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License Number State | MI
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Taxonomy #12
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD2017-0836
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License Number State | NM
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Taxonomy #13
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 254620-1
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License Number State | NY
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Taxonomy #14
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD417803
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License Number State | PA
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Taxonomy #15
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 01079763A
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License Number State | IN
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