Provider Demographics
NPI:1124057229
Name:SRIPAIPAN, RAJANEE (MD)
Entity type:Individual
Prefix:DR
First Name:RAJANEE
Middle Name:
Last Name:SRIPAIPAN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1569
Mailing Address - Country:US
Mailing Address - Phone:906-483-1700
Mailing Address - Fax:906-483-1717
Practice Address - Street 1:500 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1569
Practice Address - Country:US
Practice Address - Phone:906-483-1700
Practice Address - Fax:906-483-1717
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI43032300208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104362008Medicaid
MI0C16002OtherMEDICARE GROUP
MI0829560001OtherMEDICARE DME
MIRS032300OtherBLUECROSS STATE ID
MI0C16002OtherMEDICARE GROUP
MIRS032300OtherBLUECROSS STATE ID