Healthcare Provider Details

I. General information

NPI: 1053393702
Provider Name (Legal Business Name): MAHESH C KARAMCHANDANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 11/27/2023
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3770 CAPITAL AVE SW SUITE A
BATTLE CREEK MI
49015-9411
US

IV. Provider business mailing address

601 JOHN ST BOX 42
KALAMAZOO MI
49007-5341
US

V. Phone/Fax

Practice location:
  • Phone: 269-441-1771
  • Fax: 269-441-1773
Mailing address:
  • Phone: 269-341-8419
  • Fax: 269-341-8743

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License NumberMD050945
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: