Provider Demographics
NPI:1033186861
Name:RAMAMURTHI, KALYANA S (MD)
Entity Type:Individual
Prefix:DR
First Name:KALYANA
Middle Name:S
Last Name:RAMAMURTHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1886 W AUBURN RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3865
Mailing Address - Country:US
Mailing Address - Phone:248-290-3111
Mailing Address - Fax:248-290-3100
Practice Address - Street 1:44200 WOODWARD AVE
Practice Address - Street 2:SUIE 209
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-5045
Practice Address - Country:US
Practice Address - Phone:248-253-0330
Practice Address - Fax:248-253-1982
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301061658207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4505281Medicaid
G53044Medicare UPIN
MIM54550011Medicare ID - Type Unspecified