Provider Demographics
NPI:1124130299
Name:SANKARAN, RAJALAKSHMI (MD)
Entity type:Individual
Prefix:
First Name:RAJALAKSHMI
Middle Name:
Last Name:SANKARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5205 NORKO DR
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3027
Mailing Address - Country:US
Mailing Address - Phone:810-733-0400
Mailing Address - Fax:810-733-8638
Practice Address - Street 1:5205 NORKO DR
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-3027
Practice Address - Country:US
Practice Address - Phone:810-733-0400
Practice Address - Fax:810-733-8638
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRS043426208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1001841OtherMCLAREN HEALTH PLAN
MI4106643Medicaid
MI3S2509182OtherHEALTH PLUS OF MICHIGAN
MIP62874OtherBLUE CARE NETWORK