Provider Demographics
NPI:1740358035
Name:ASTHMA & ALLERGY CENTERS OF CENTRAL MICHIGAN, PLC
Entity type:Organization
Organization Name:ASTHMA & ALLERGY CENTERS OF CENTRAL MICHIGAN, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:BABU
Authorized Official - Last Name:AVULA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-484-3966
Mailing Address - Street 1:1515 LAKE LANSING RD
Mailing Address - Street 2:G1
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-3753
Mailing Address - Country:US
Mailing Address - Phone:517-484-3966
Mailing Address - Fax:517-484-9279
Practice Address - Street 1:1515 LAKE LANSING RD
Practice Address - Street 2:G1
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-3753
Practice Address - Country:US
Practice Address - Phone:517-484-3966
Practice Address - Fax:517-484-9279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIRA056534174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty