Individual
K P. RAVIKRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3535 W 13 MILE RD, STE. 507, ROYAL OAK, MI 48073-6710
(248) 551-0497
Mailing address
130 TOWN CENTER DRIVE, SUITE 203, TROY, MI 48084-1744
(248) 585-8221
(248) 585-8270
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
4301032933
MI
207RP1001X
Pulmonary Disease Physician
Primary
4301032933
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1566256
—
MI
01
—
290F361080
BCBSM
MI
Enumeration date
03/27/2006
Last updated
07/06/2017
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