Active NPI
Giriraj Ethiraju, MA SLP
- Speech-Language Pathologist
- Canton, MI
National Provider Identifier
1750759825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 7101000753
- Practice address
- 8230 Nectar Drive
Apt 726
Canton, MI 48187 - Phone
- (734) 502-8808
- NPI assigned
- Sep 8, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 7101000753 | MI | Primary |
Addresses
Primary practice location
8230 Nectar Drive
Apt 726
Canton, MI 48187
Mailing address
8230 Nectar Dr
Apt 726
Canton, MI 48187-7117
Phone (734) 502-8808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7101000753 | MI | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1750759825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8230 NECTAR DR",
"address_2": "APT 726",
"city": "CANTON",
"state": "MI",
"postal_code": "481877117",
"telephone_number": "734-502-8808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8230 NECTAR DRIVE",
"address_2": "APT 726",
"city": "CANTON",
"state": "MI",
"postal_code": "48187",
"telephone_number": "734-502-8808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETHIRAJU",
"first_name": "GIRIRAJ",
"credential": "MA SLP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-09-08",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MI",
"license": "7101000753",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.