Provider Demographics
NPI:1821197435
Name:NAGAPPAN, RAMANATHAN (MD)
Entity type:Individual
Prefix:
First Name:RAMANATHAN
Middle Name:
Last Name:NAGAPPAN
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 1:1200 E MICHIGAN AVE STE 725
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1832
Mailing Address - Country:US
Mailing Address - Phone:517-364-5599
Mailing Address - Fax:517-364-5590
Practice Address - Street 1:1200 E MICHIGAN AVE STE 725
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1832
Practice Address - Country:US
Practice Address - Phone:517-364-5599
Practice Address - Fax:517-364-5590
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43149207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2500031OtherPHYSICIANS HEALTH PLAN
MI139840OtherGREAT LAKES HEALTH PLAN
MI1425801Medicaid
MIC2100OtherMCARE
MIRN043149OtherBCBS
MI2570131OtherPHYS HEALTH PLAN FAMILY
MI1228780003OtherWELLNESS PLAN
MI201602OtherMCLAREN
MIRN043149OtherBLUE CARE NETWORK
MI110091891OtherTRAVELERS MEDICARE
MI1425801Medicaid
MIRN043149OtherBCBS