Provider Demographics
NPI:1407920846
Name:SAI RAMESH BIKKINA MD PC
Entity Type:Organization
Organization Name:SAI RAMESH BIKKINA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAI
Authorized Official - Middle Name:RAMESH
Authorized Official - Last Name:BIKKINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-667-4994
Mailing Address - Street 1:1057 SUNCREST DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-4404
Mailing Address - Country:US
Mailing Address - Phone:810-667-4994
Mailing Address - Fax:810-667-8041
Practice Address - Street 1:1057 SUNCREST DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-4404
Practice Address - Country:US
Practice Address - Phone:810-667-4994
Practice Address - Fax:810-667-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-18
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI047380207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11 04400221OtherHEALTH PLUS
MIC6046OtherMCARE
MI3113705Medicaid
MI11 04400221OtherHEALTH PLUS
MI0440022Medicare ID - Type Unspecified