Provider Demographics
NPI:1962935650
Name:SHENOY RANJAL, ROHIT
Entity type:Individual
Prefix:MR
First Name:ROHIT
Middle Name:
Last Name:SHENOY RANJAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2799 W. GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-916-3056
Mailing Address - Fax:313-916-5811
Practice Address - Street 1:2799 W. GRAND BOULEVARD
Practice Address - Street 2:HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-2608
Practice Address - Country:US
Practice Address - Phone:313-916-3056
Practice Address - Fax:313-916-5811
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301112920208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery