Healthcare Provider Details

I. General information

NPI: 1962336073
Provider Name (Legal Business Name): MEENAKSHI SUNDARAM RAMACHANDRAN MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W 13 MILE RD
ROYAL OAK MI
48073-6712
US

IV. Provider business mailing address

17321 NE 116TH CT
REDMOND WA
98052-2357
US

V. Phone/Fax

Practice location:
  • Phone: 248-898-5000
  • Fax:
Mailing address:
  • Phone: 425-628-7728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number4351056797
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: