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Individual

SUDHA RUDRARAJU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
HENRY FORD HEALTH SYSTEM, 24565 HAIG ROAD, TAYLOR, MI 48180
(313) 375-2000
(313) 375-2235
Mailing address
HENRY FORD HEALTH SYSTEM, 24565 HAIG ROAD, TAYLOR, MI 48180
(313) 375-2000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301062364
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
327180210
MI
01
700H262280
BLUE CROSS-BLUE CROSS
01
SR062364
CHAMPUS-CHAMPUS
Enumeration date
01/04/2007
Last updated
08/01/2012
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