Provider Demographics
NPI:1639268709
Name:RAMASWAMI, GANESH (MD)
Entity Type:Individual
Prefix:DR
First Name:GANESH
Middle Name:
Last Name:RAMASWAMI
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 1:12701 TELEGRAPH RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-6847
Mailing Address - Country:US
Mailing Address - Phone:734-287-1950
Mailing Address - Fax:734-287-1954
Practice Address - Street 1:12701 TELEGRAPH RD
Practice Address - Street 2:SUITE 102
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-6847
Practice Address - Country:US
Practice Address - Phone:734-287-1950
Practice Address - Fax:734-287-1954
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086629208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4763811Medicaid
MI020G361410OtherBCBSM
MI4301086629OtherLICENSE
MI1001254OtherHEALTHPLUS
MI150753OtherGREAT LAKES HEALTH PLAN
MI150753OtherGREAT LAKES HEALTH PLAN
MI1001254OtherHEALTHPLUS