Provider Demographics
NPI:1700010311
Name:KARIA, PRATIMA (MD)
Entity Type:Individual
Prefix:
First Name:PRATIMA
Middle Name:
Last Name:KARIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1257 KIRTS BLVD
Mailing Address - Street 2:APT 104
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4810
Mailing Address - Country:US
Mailing Address - Phone:409-550-2736
Mailing Address - Fax:
Practice Address - Street 1:4201 SAINT ANTOINE ST # 3L8
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2153
Practice Address - Country:US
Practice Address - Phone:409-550-2736
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-11
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010875722085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology