Individual
DR. ILYA RAKITIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, HENRY FORD HOSPITAL, GRADUATE MEDICAL EDUCATION, CFP-04, DETROIT, MI 48202-2608
(313) 916-1601
Mailing address
6350 PEPPER HILL ST, WEST BLOOMFIELD, MI 48322-2303
(248) 229-9699
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301504446
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2015
Last updated
06/22/2021
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