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Individual

RAJAPRABHAKARAN RAJARETHINAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3001 PLYMOUTH RD, SUITE 107, ANN ARBOR, MI 48105-3205
(734) 846-2898
Mailing address
3001 PLYMOUTH RD, SUITE 107, ANN ARBOR, MI 48105-3205
(734) 846-2898

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6301013432
MI
2084P0800X
Psychiatry Physician
250229
MA
2084P0800X
Psychiatry Physician
Primary
4301064033
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0P30630251
MEDICARE NUMBER
MI
05
4902521
MI
Enumeration date
06/01/2006
Last updated
02/13/2015
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