Provider Demographics
NPI:1477669893
Name:ALAVALAPATI, RAMA KRISHNA (MD)
Entity Type:Individual
Prefix:
First Name:RAMA
Middle Name:KRISHNA
Last Name:ALAVALAPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAMA
Other - Middle Name:KRISHNA
Other - Last Name:ALAVALAPATI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11900 TWELVE MILE ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093
Mailing Address - Country:US
Mailing Address - Phone:586-558-9033
Mailing Address - Fax:586-573-4209
Practice Address - Street 1:11900 TWELVE MILE ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093
Practice Address - Country:US
Practice Address - Phone:586-558-9033
Practice Address - Fax:586-573-4209
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051374207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3127792Medicaid
F66044Medicare UPIN
0828918Medicare ID - Type Unspecified