Provider Demographics
NPI:1407827280
Name:MOHINDRA, RAMESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:K
Last Name:MOHINDRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15132 LEVAN RD
Mailing Address - Street 2:STE. 32
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-5027
Mailing Address - Country:US
Mailing Address - Phone:734-779-2123
Mailing Address - Fax:734-779-2163
Practice Address - Street 1:15132 LEVAN RD
Practice Address - Street 2:STE. 32
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5027
Practice Address - Country:US
Practice Address - Phone:734-779-2123
Practice Address - Fax:734-779-2163
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033586174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIB43495Medicare UPIN
MI0827930Medicare ID - Type Unspecified