Individual
DR. RAVICHAND MADALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 LAKE DR SE STE 200, GRAND RAPIDS, MI 49546-8292
(616) 391-3759
(616) 391-3052
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6557
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.089399
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
4301102594
MI
2084N0400X
Neurology Physician
35089399
OH
Other
Enumeration date
03/22/2007
Last updated
02/25/2021
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