Individual
SANTOSH K RASTOGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 967-7480
Mailing address
837 JORDAN DR, TROY, MI 48098-5627
(248) 879-6459
(248) 828-9712
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301049068
MI
2084P0805X
Geriatric Psychiatry Physician
4301049068
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093711459
NPI - CCC
MI
05
—
3015553
—
MI
01
—
MI5414
MEDICARE PTAN GROUP
MI
01
—
MI5414001
MEDICARE PTAN INDIVIDUAL
MI
Enumeration date
08/24/2006
Last updated
06/08/2012
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