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General NPI Number Information
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NPI Number | 1780812065
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Entity Type | Individual
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Provider Name | CAROL ANN RAJDA RN
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Gender | Female
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Dates
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Enumeration Date | 06/25/2009
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Last Update Date | 06/25/2009
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Provider Practice Location Address
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Address Line | 2799 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48202-2608
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Country | US
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Telephone | 313-916-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 4810 BARBER RD
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City | METAMORA
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State | MI
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Zip | 48455-9231
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Country | US
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Telephone | 810-678-3802
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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 | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 4704128622
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License Number State | MI
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