Provider Demographics
NPI:1063517142
Name:KARNANI, RAJIL MOHAN (MD)
Entity type:Individual
Prefix:
First Name:RAJIL
Middle Name:MOHAN
Last Name:KARNANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 SERVICE RD
Mailing Address - Street 2:A201
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48824-7015
Mailing Address - Country:US
Mailing Address - Phone:517-884-2976
Mailing Address - Fax:517-432-3928
Practice Address - Street 1:804 SERVICE RD
Practice Address - Street 2:A225
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48824-7015
Practice Address - Country:US
Practice Address - Phone:517-353-4941
Practice Address - Fax:517-432-3145
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA36612207R00000X
OH85477207R00000X
MI4301098006207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0740985Medicaid
MI1063517142Medicaid
IA27807OtherWELLMARK BCBS
I66137Medicare UPIN
IA27807OtherWELLMARK BCBS
MI1063517142Medicaid