Individual
DR. VENKAT CHINNA RUDRARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 OAKWOOD BLVD, DEARBORN, MI 48124-2319
(313) 359-7600
(313) 359-7678
Mailing address
840 OAKWOOD BLVD, DEARBORN, MI 48124-2319
(313) 359-7600
(313) 359-7678
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301067927
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301067927
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300132548
RAILROAD MEDICARE
MI
05
—
4406149
—
MI
Enumeration date
07/03/2006
Last updated
01/30/2024
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