Provider Demographics
NPI:1477630135
Name:SETTY, RAVI CHIKKA (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:CHIKKA
Last Name:SETTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R C
Other - Middle Name:
Other - Last Name:RAVIKUMAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 HURLEY PLZ
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-5902
Mailing Address - Country:US
Mailing Address - Phone:810-257-9284
Mailing Address - Fax:
Practice Address - Street 1:1 HURLEY PLZ
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-5902
Practice Address - Country:US
Practice Address - Phone:810-257-9284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082953207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4587788-10Medicaid
MI7070558OtherAETNA
MII03802Medicare UPIN
MIP00121251Medicare ID - Type UnspecifiedRAILROAD
MI0M34690013Medicare ID - Type Unspecified