Provider Demographics
NPI:1558388330
Name:KALAPPARAMBATH, TOMY PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMY
Middle Name:PAUL
Last Name:KALAPPARAMBATH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:G3239 BEECHER RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3616
Mailing Address - Country:US
Mailing Address - Phone:810-733-6780
Mailing Address - Fax:
Practice Address - Street 1:G3239 BEECHER RD
Practice Address - Street 2:SUITE F
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3616
Practice Address - Country:US
Practice Address - Phone:810-733-6780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010824292085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI300B511530OtherBCBS OF MI
MI4905499Medicaid
MI300B560780OtherBCBS OF MI
MI4903921100Medicaid
MIP00333538OtherRAILROAD MEDICARE
MI1023408OtherMCLAREN HEALTH PLAN
MI300B563870OtherBCBS OF MI
MI4903921OtherMOLINA HEALTHCARE
MIRA820073OtherMCARE
MI4924930Medicaid
MI300F318310OtherBCBS OF MI
MI4904393OtherMOLINA
MI4909390100Medicaid
MIP00338014OtherRAILROAD MEDICARE
MI4904393100Medicaid