Provider Demographics
NPI:1952353880
Name:VEMURI, RAMACHANDRA RAO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMACHANDRA
Middle Name:RAO
Last Name:VEMURI
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 1:5148 CREST KNOLLS CT
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-2649
Mailing Address - Country:US
Mailing Address - Phone:248-539-0865
Mailing Address - Fax:
Practice Address - Street 1:13225 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1070
Practice Address - Country:US
Practice Address - Phone:734-284-7563
Practice Address - Fax:734-284-6174
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301050423174400000X
MIRV050423207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist