Basic Information
Provider Information
NPI: 1124142294
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BAKSHI
FirstName: RISHI
MiddleName: RAI
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481081633
CountryCode: US
TelephoneNumber: 7346475299
FaxNumber:  
Practice Location
Address1: 325 E EISENHOWER PKWY
Address2: SUITE 100
City: ANN ARBOR
State: MI
PostalCode: 481085744
CountryCode: US
TelephoneNumber: 7349367175
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/16/2007
LastUpdateDate: 06/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2081P2900X5101015962MIN Allopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
208100000X5101015962MIY Allopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation 

No ID Information.


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