Provider Demographics
NPI:1518120484
Name:RAMADAS, PREMASUDHA C (MD)
Entity Type:Individual
Prefix:
First Name:PREMASUDHA
Middle Name:C
Last Name:RAMADAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1170 CHARTER DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3587
Mailing Address - Country:US
Mailing Address - Phone:810-733-5000
Mailing Address - Fax:810-733-5284
Practice Address - Street 1:1170 CHARTER DR
Practice Address - Street 2:SUITE A
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3587
Practice Address - Country:US
Practice Address - Phone:810-733-5000
Practice Address - Fax:810-733-5284
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301092299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine