Provider Demographics
NPI:1508847906
Name:COLON AND RECTAL SURGERY CENTER PC
Entity Type:Organization
Organization Name:COLON AND RECTAL SURGERY CENTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:KARAMCHANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-441-1771
Mailing Address - Street 1:3770 CAPITAL AVE SW
Mailing Address - Street 2:STE A
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-9411
Mailing Address - Country:US
Mailing Address - Phone:269-441-1771
Mailing Address - Fax:269-441-1773
Practice Address - Street 1:3770 CAPITAL AVE SW
Practice Address - Street 2:STE A
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-9411
Practice Address - Country:US
Practice Address - Phone:269-441-1771
Practice Address - Fax:269-441-1773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2011-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0A36339Medicare ID - Type Unspecified