Provider Demographics
NPI:1386023356
Name:RAMA, AMIT (DO)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:RAMA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22625 TORINO DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3332
Mailing Address - Country:US
Mailing Address - Phone:248-910-4802
Mailing Address - Fax:
Practice Address - Street 1:1 GENESYS PKWY
Practice Address - Street 2:OFFICE OF MEDICAL EDUCATION
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8065
Practice Address - Country:US
Practice Address - Phone:248-910-4802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-24
Last Update Date:2015-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101021678207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine