MEDICARE: DR. SANJEEV SHANMUGA VENKATARAMAN 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
1	2084P0800X	Psychiatry Physician	SV056477	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629120282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJEEV SHANMUGA VENKATARAMAN M.D.

Provider Business Mailing Address
First Line	:	4639 RAVINE DR
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48301-3640
Country	:	US
Telephone Number	:	248-737-4525
Fax Number	:	248-290-5401

Provider Business Practice Location Address
First Line	:	W-4111 ANDOVER RD STE 125
Second Line	:
City	:	BLOOMFIELD TOWNSHIP
State	:	MI
Zip	:	48302-1931
Country	:	US
Telephone Number	:	248-737-4525
Fax Number	:	248-290-5401

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	02/12/2026

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