Individual
SANJAY V RAIKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 FRANCISCAN WAY, MICHIGAN CITY, IN 46360-0021
(219) 852-1524
(219) 933-2288
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01067950A
IN
208M00000X
Hospitalist Physician
Primary
01067950A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000722207
ANTHEM TRADITIONAL
IN
05
—
200985750
—
IN
01
—
616679523
DEPARTMENT OF LABOR
IN
01
—
P01254386
MEDICARE RR
IN
Enumeration date
08/23/2010
Last updated
04/18/2025
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