1609043371 NPI number — DINDIGALLA V RAMANA MD PC

Table of content: (NPI 1609043371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609043371 NPI number — DINDIGALLA V RAMANA MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DINDIGALLA V RAMANA MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609043371
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 N MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAPEER
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48446-1352
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
810-667-9390
Provider Business Mailing Address Fax Number:
810-667-9341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 N MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAPEER
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48446-1352
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
810-667-9390
Provider Business Practice Location Address Fax Number:
810-667-9341
Provider Enumeration Date:
05/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RAMANA
Authorized Official First Name:
DINDIGALLA
Authorized Official Middle Name:
V
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
810-667-9390

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  4301034635 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A74160 . This is a "HAP" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 0445090 . This is a "BCN" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 1002080 . This is a "MCLAREN HEALTH" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 340020639 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 3450902 . This is a "HEALTH PLUS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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