Provider Demographics
NPI:1922178003
Name:KAZA, RAMARAO (MD)
Entity Type:Individual
Prefix:
First Name:RAMARAO
Middle Name:
Last Name:KAZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4160 JOHN R STREET
Mailing Address - Street 2:SUITE 809
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-831-2700
Mailing Address - Fax:313-831-0430
Practice Address - Street 1:4160 JOHN R STREET
Practice Address - Street 2:SUITE 809
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-831-2700
Practice Address - Fax:313-831-0430
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301033043208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0829132OtherBLUE CROSS
MI1092590Medicaid
MI0829132OtherBLUE CROSS
MI1092590Medicaid