Provider Demographics
NPI:1053481853
Name:RAMALINGAM, YAMINI (MD)
Entity Type:Individual
Prefix:DR
First Name:YAMINI
Middle Name:
Last Name:RAMALINGAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-1553
Mailing Address - Country:US
Mailing Address - Phone:810-636-2231
Mailing Address - Fax:810-636-7174
Practice Address - Street 1:7320 S STATE RD
Practice Address - Street 2:
Practice Address - City:GOODRICH
Practice Address - State:MI
Practice Address - Zip Code:48438-9292
Practice Address - Country:US
Practice Address - Phone:810-636-2231
Practice Address - Fax:810-636-7174
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080418207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4821791Medicaid
MI4821791Medicaid
MIP20530001Medicare ID - Type UnspecifiedM.D.