Provider Demographics
NPI:1285850057
Name:RAMESH C KAKATY M D ASSOC P C
Entity Type:Organization
Organization Name:RAMESH C KAKATY M D ASSOC P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAKATY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-733-2700
Mailing Address - Street 1:433 SEMINOLE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3743
Mailing Address - Country:US
Mailing Address - Phone:231-733-2700
Mailing Address - Fax:231-733-6425
Practice Address - Street 1:433 SEMINOLE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49444-3743
Practice Address - Country:US
Practice Address - Phone:231-733-2700
Practice Address - Fax:231-733-6425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301037161207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1440755Medicaid
MI1440755Medicaid
MIE40185Medicare UPIN