Provider Demographics
NPI:1710987847
Name:PERLA, RATNAVALI BUTCHI (MD)
Entity Type:Individual
Prefix:
First Name:RATNAVALI
Middle Name:BUTCHI
Last Name:PERLA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1213
Mailing Address - Country:US
Mailing Address - Phone:248-662-4091
Mailing Address - Fax:248-662-0365
Practice Address - Street 1:26850 PROVIDENCE PKWY
Practice Address - Street 2:SUITE 320
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1213
Practice Address - Country:US
Practice Address - Phone:248-662-4091
Practice Address - Fax:248-662-0365
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2015-03-17
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Provider Licenses
StateLicense IDTaxonomies
MI43010433682080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1770115-10Medicaid
MI453429210Medicaid
MI177011510Medicaid
MI1770115-10Medicaid
MI177011510Medicaid