Individual
EQDAM N RADHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14726 CHAMPAIGN RD, ALLEN PARK, MI 48101-1617
(313) 789-7968
(137) 897-9673
Mailing address
14726 CHAMPAIGN RD, ALLEN PARK, MI 48101-1617
(313) 789-7968
(137) 897-9673
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01066948A
IN
207R00000X
Internal Medicine Physician
Primary
4301088706
MI
208M00000X
Hospitalist Physician
01066948A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000626696
ANTHEM
IN
05
—
200946390
—
IN
Enumeration date
02/13/2008
Last updated
10/11/2022
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