Individual
MR. RAVI KIRAN LAKKARAJU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3190 E MIDLAND RD, BAY CITY, MI 48706-2755
(989) 667-6650
(989) 667-6660
Mailing address
6022 E MEADOW DR, BAY CITY, MI 48706-9081
(989) 667-6650
(989) 667-6660
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
RL077577
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4442940
—
MI
01
—
RL077577
STATE LICENSE
MI
Enumeration date
10/26/2005
Last updated
01/25/2010
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