person
Ethiraj Govinda Raj, MD
Specialist in Flint, Michigan
NPI 1376532556

Ethiraj Govinda Raj is a Specialist based in Flint, MI. Ethiraj Govinda Raj practices in Flint, MI and has the professional credentials of MD. The NPI Number for Ethiraj Govinda Raj is 1376532556 and holds a License No. 4301039365 (Michigan).

The current practice location address for Ethiraj Govinda Raj is 1165 S Linden Rd, Flint, MI and can be reached out via phone at 810-732-5400 and via fax at 810-733-1624.

Location: 1165 S Linden Rd, Flint, MI, 48532-3406
person
Provider Profile Details
NPI Number
1376532556
Provider Name
Ethiraj Govinda Raj
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1165 S Linden Rd, Flint, MI, 48532-3406
Phone Number
810-732-5400
Fax Number
810-733-1624
Provider Enumeration Date
10/19/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1100482 01 MI HEALTH PLUS OF MICHIGAN
ER039365 01 MI STATE LICENSE NUMBER
0B51240, ER039365 01 MI BLUE CARE NETWORK
C1855 01 MI MCARE
1010892 01 MI MCLAREN HEALTH PLAN
0B51240 01 MI BLUE CROSS BLUE SHIELD MI
1010892 01 MI MCLAREN HEALTH ADVANTAGE
4591753 05 MI
institution
Provider Business Practice Location Address Details
Address
1165 S Linden Rd
City
State
Zip
48532-3406
Phone Number
810-732-5400
Fax Number
810-733-1624
person
Provider Business Mailing Address Details
Address
1165 S Linden Rd
City
State
Zip
48532-3406
Phone Number
810-732-5400
Fax Number
810-733-1624
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
4301039365 (Michigan)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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