Provider Demographics
NPI:1407928161
Name:DEOL, RAMANPAL K (OD)
Entity Type:Individual
Prefix:
First Name:RAMANPAL
Middle Name:K
Last Name:DEOL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:RAMANPAL
Other - Middle Name:K
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12843 HERITAGE
Mailing Address - Street 2:#204
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2995
Mailing Address - Country:US
Mailing Address - Phone:734-459-6205
Mailing Address - Fax:
Practice Address - Street 1:37550 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3923
Practice Address - Country:US
Practice Address - Phone:734-542-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004339152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist