Individual
DR. PINNAMANENI RAMAKRISHNA PRASAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16407 SOUTHFIELD RD, STE A, ALLEN PARK, MI 48101-2571
(313) 271-3000
(313) 271-3003
Mailing address
PO BOX 77000 DEPT 771255, DETROIT, MI 48277-2000
(313) 271-3000
(313) 271-3003
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
4301036210
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110179431C30371
TRAVELERS MEDICARE
MI
01
—
110Q26434
BCBS
MI
01
—
118544
GREAT LAKES HEALTH PLAN
MI
01
—
120671
CARE CHOICES
MI
05
—
18210990445
—
MI
01
—
204980
FEDERAL BLACK LUNG
MI
01
—
3575
CAPE HEALTH PLAN
MI
05
—
4241568
—
MI
01
—
4540391
AETNA
MI
01
—
C5579
M-CARE
MI
01
—
G02484
BLUECARE NETWORK
MI
01
—
P99362
BLUECARE NETWORK
MI
Enumeration date
08/10/2005
Last updated
01/30/2019
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