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Organization

PENUMETSA R RAJU, M.D.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PENUMETSA, R RAJU (AUTHORIZED REPRESENTATIVE)
(989) 776-8033
Entity
Organization

Contact information

Practice address
590 CANTERBURY DR, SAGINAW, MI 48638-5876
(989) 776-8033
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary

Other

Enumeration date
06/13/2006
Last updated
09/19/2007
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