Provider Demographics
NPI:1619226388
Name:GANESH RAMASWAMI M.D. P.C.
Entity Type:Organization
Organization Name:GANESH RAMASWAMI M.D. P.C.
Other - Org Name:GANESH RAMASWAMI M.D. P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GANESH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMASWANU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-450-0496
Mailing Address - Street 1:721 N MACOMB ST
Mailing Address - Street 2:STE 6
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2982
Mailing Address - Country:US
Mailing Address - Phone:734-299-3004
Mailing Address - Fax:734-299-3144
Practice Address - Street 1:721 N MACOMB ST
Practice Address - Street 2:STE 6
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2982
Practice Address - Country:US
Practice Address - Phone:734-299-3004
Practice Address - Fax:734-299-3144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086629174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty