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NPI Code Detail

MEDICARE: ADITHI RAJAGOPALAN

MEDICARE: ADITHI RAJAGOPALAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1326782525
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADITHI RAJAGOPALAN
Provider Business Mailing Address
First Line : 940 CRICKLEWOOD DR APT 237
Second Line :
City : STATE COLLEGE
State : PA
Zip : 16803-1817
Country : US
Telephone Number : 267-316-8561
Fax Number :
Provider Business Practice Location Address
First Line : 632 N MILL ST
Second Line :
City : PLYMOUTH
State : MI
Zip : 48170-1422
Country : US
Telephone Number : 810-488-1202
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2022
Last Update Date : 04/24/2022

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Directions to “ ADITHI RAJAGOPALAN ” Practice Location

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