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NPI Code Detail

MEDICARE: DR. RAJENDRA PRASAD M.D.

MEDICARE: DR. RAJENDRA PRASAD M.D.
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
1207RC0000XCardiovascular Disease Physician4301038558MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3060053571OTHERMIRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10F37550OTHERMIBCN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
40F37550OTHERMIBCBSM

General Provider Information

NPI Number : 1619937885
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAJENDRA PRASAD M.D.
Provider Business Mailing Address
First Line : 645 BARCLAY CIR
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-5804
Country : US
Telephone Number : 248-844-1010
Fax Number : 248-844-9089
Provider Business Practice Location Address
First Line : 645 BARCLAY CIR
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-5804
Country : US
Telephone Number : 248-844-1010
Fax Number : 248-844-9089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 11/27/2023

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