Basic Information
Provider Information
NPI: 1588842017
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAJAII
FirstName: FATEMEH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD/PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 SOUTH STATE STREET
Address2: 700 KMS PLACE
City: ANN ARBOR
State: MI
PostalCode: 48108
CountryCode: US
TelephoneNumber: 7349362047
FaxNumber:  
Practice Location
Address1: 1000 WALL ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481051912
CountryCode: US
TelephoneNumber: 7347644190
FaxNumber: 7346478052
Other Information
ProviderEnumerationDate: 02/06/2008
LastUpdateDate: 07/31/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000XP24456MDN Allopathic & Osteopathic PhysiciansOphthalmology 
207W00000X4301102310MIY Allopathic & Osteopathic PhysiciansOphthalmology 
207R00000X4301102310MIN Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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