Provider Demographics
NPI:1790521938
Name:RAJENDRAN, LUCKSHI (MD, FRCSC, FACS)
Entity type:Individual
Prefix:DR
First Name:LUCKSHI
Middle Name:
Last Name:RAJENDRAN
Suffix:
Gender:F
Credentials:MD, FRCSC, FACS
Other - Prefix:DR
Other - First Name:LUCKSHIKA
Other - Middle Name:
Other - Last Name:RAJENDRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2911 WEST GRAND BOULEVARD, APT 2133
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-900-6169
Mailing Address - Fax:
Practice Address - Street 1:2799 WEST GRAND BOULEVARD HENRY FORD HOSPITAL
Practice Address - Street 2:CFP-2
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-916-2941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2025-10-17
Deactivation Date:2025-04-03
Deactivation Code:
Reactivation Date:2025-10-17
Provider Licenses
StateLicense IDTaxonomies
MI4351052960204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery