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Individual

RAJEEV DEVESHWAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25 MICHIGAN ST NE STE 6100, SPECTRUM HEALTH MEDICAL GROUP NEUROVASCULAR/STROKE OFFI, GRAND RAPIDS, MI 49503-2561
(616) 267-7900
(616) 267-7901
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
036100789
IL
2084V0102X
Vascular Neurology Physician
Primary
4301053380
MI
2085R0202X
Diagnostic Radiology Physician
036100789
IL
2085R0202X
Diagnostic Radiology Physician
4301053380
MI
2085R0204X
Vascular & Interventional Radiology Physician
036100789
IL
2085R0204X
Vascular & Interventional Radiology Physician
4301053380
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
206147
MEDICARE PTAN (GROUP)
01
206147039
MEDICARE PTAN (INDIVIDUAL)
01
CA4748
MEDICARE RAILROAD (GROUP)
01
P00904920
MEDICARE RAILROAD (INDIVIDUAL)
Enumeration date
06/05/2006
Last updated
12/08/2015
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