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Individual

KRISHNAN RAGHAVENDRAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301063260
MI
2086S0102X
Surgical Critical Care Physician
Primary
4301063260
MI
2086S0127X
Trauma Surgery Physician
219095
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02091261
NY
Enumeration date
07/15/2006
Last updated
10/13/2025
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