Provider Demographics
NPI:1336314210
Name:KATRANJI RECONSTRUCTIVE SURGERY INSTITUTE, PLLC
Entity Type:Organization
Organization Name:KATRANJI RECONSTRUCTIVE SURGERY INSTITUTE, PLLC
Other - Org Name:KRSI;KATRANJI HAND CENTER;MICHIGANTHERAPY CENTER;MERIDIAN SURGEONS;
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ABDALMAJID
Authorized Official - Middle Name:
Authorized Official - Last Name:KATRANJI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MBA
Authorized Official - Phone:517-332-4263
Mailing Address - Street 1:2111 MERRITT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6916
Mailing Address - Country:US
Mailing Address - Phone:517-332-4263
Mailing Address - Fax:517-332-1132
Practice Address - Street 1:2111 MERRITT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6916
Practice Address - Country:US
Practice Address - Phone:517-332-4263
Practice Address - Fax:517-332-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-23
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010808282086S0105X, 2086S0122X
MI5201003736225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6253670001Medicare NSC