Individual
DR. KRISHNA THAVARAJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, PULM K-17, DETROIT, MI 48202-2689
(313) 916-2421
(313) 916-9102
Mailing address
2799 W GRAND BLVD, PULM K-17, DETROIT, MI 48202-2689
(313) 916-2421
(313) 916-9102
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
036-111635
IL
207RP1001X
Pulmonary Disease Physician
Primary
4301095535
MI
Other
Enumeration date
04/12/2007
Last updated
10/10/2013
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