Provider Demographics
NPI:1164402442
Name:GARG, RAM S (MD)
Entity Type:Individual
Prefix:DR
First Name:RAM
Middle Name:S
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14625 TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-4637
Mailing Address - Country:US
Mailing Address - Phone:734-671-8744
Mailing Address - Fax:734-671-7654
Practice Address - Street 1:14625 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-4637
Practice Address - Country:US
Practice Address - Phone:734-671-8744
Practice Address - Fax:734-671-7654
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRG0580882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4262843OtherAETNA
MI4441261OtherTEAMSTERS
MI85858-AOtherHAP
MI101827OtherCARE CHOICES
MI1308283632OtherBLUE CROSS
MIRG058088OtherSTATE LICENSE
MI2915763 TYPE 10Medicaid
MI2915763Medicaid
MI130008732OtherRAILROAD MEDICARE
MI2915763-10Medicaid
MI500109770OtherTRICARE
MI4441261OtherTEAMSTERS
MI130008732OtherRAILROAD MEDICARE
MI4262843OtherAETNA