Individual
DR. PRADEEP NAGARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 W 13 MILE RD, SUITE 407, ROYAL OAK, MI 48073-6770
(248) 551-0638
(248) 355-1449
Mailing address
20952 E 12 MILE RD, SUITE 200, SAINT CLAIR SHORES, MI 48081-3200
(586) 771-4820
(586) 771-6620
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
4301083042
MI
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
4301083042
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0E06273
BCBSM
MI
01
—
PN083042
BCBSM LICENCE NUMBER
MI
Enumeration date
11/14/2005
Last updated
09/11/2014
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