Provider Demographics
NPI:1205984457
Name:CHHEDA, RAMESH LAKHAMSHI (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:LAKHAMSHI
Last Name:CHHEDA
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 1:5154 MILLER RD
Mailing Address - Street 2:STE I
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-1065
Mailing Address - Country:US
Mailing Address - Phone:810-720-7801
Mailing Address - Fax:810-720-7803
Practice Address - Street 1:5154 MILLER RD
Practice Address - Street 2:SUIT I
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-1065
Practice Address - Country:US
Practice Address - Phone:810-720-7801
Practice Address - Fax:810-720-7803
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301045264261QP2300X, 2084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4301045264OtherSTATE LICENSE
MI382777512OtherTAX ID
MI3502502562OtherBLUE CROSS BLUE SHIELD
MI1867240 10Medicaid
MIOP24510Medicare ID - Type Unspecified001 SOUTHFIELD
MI382777512OtherTAX ID
MIOP24500Medicare ID - Type Unspecified099