Provider Demographics
NPI:1083846265
Name:RAMAKRISHNAN, RAKESH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:
Last Name:RAMAKRISHNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:21031 MICHIGAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2339
Mailing Address - Country:US
Mailing Address - Phone:313-277-6700
Mailing Address - Fax:313-277-2483
Practice Address - Street 1:21031 MICHIGAN AVENUE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2339
Practice Address - Country:US
Practice Address - Phone:313-277-6700
Practice Address - Fax:313-277-2483
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095433207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery