Provider Demographics
NPI:1023330552
Name:THIMMIAH RAMESH, M.D. P.C.
Entity type:Organization
Organization Name:THIMMIAH RAMESH, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:THIMMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:734-283-8811
Mailing Address - Street 1:2271 EUREKA RD
Mailing Address - Street 2:
Mailing Address - City:WYANDOTTE
Mailing Address - State:MI
Mailing Address - Zip Code:48192-6018
Mailing Address - Country:US
Mailing Address - Phone:734-283-8811
Mailing Address - Fax:734-283-6768
Practice Address - Street 1:2271 EUREKA RD
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-6018
Practice Address - Country:US
Practice Address - Phone:734-283-8811
Practice Address - Fax:734-283-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1138277842OtherBCBSM
MI57256AOtherHEALTH ALLIANCE PLAN (HAP) OF MICHIGAN
1138277842OtherBCBSM