Healthcare Provider Details

I. General information

NPI: 1669727715
Provider Name (Legal Business Name): RICHA TIKARIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 S HAGADORN RD STE 100
EAST LANSING MI
48823-5386
US

IV. Provider business mailing address

804 SERVICE RD STE A202
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-353-4941
  • Fax: 517-432-3145
Mailing address:
  • Phone: 517-353-4941
  • Fax: 517-432-3145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301100365
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: