Individual
RAVIPRASENNA KUMAR PARASURAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1500 E MEDICAL CENTER DR, 1ST FLOOR TAUBMAN CENTER RECP G, ANN ARBOR, MI 48109-5334
(800) 333-9013
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301063101
MI
207RN0300X
Nephrology Physician
Primary
4301063101
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347486010
—
MI
01
—
700H262220
BLUE CROSS-BLUE CROSS
—
01
—
RP063101
CHAMPUS-CHAMPUS
—
Enumeration date
12/01/2006
Last updated
01/02/2019
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