Healthcare Provider Details

I. General information

NPI: 1154482248
Provider Name (Legal Business Name): SARALA RAVIKANT MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38815 DEQUINDRE RD STE 100
TROY MI
48083
US

IV. Provider business mailing address

38815 DEQUINDRE RD STE 100
TROY MI
48083
US

V. Phone/Fax

Practice location:
  • Phone: 248-879-8080
  • Fax: 248-879-3462
Mailing address:
  • Phone: 248-879-8080
  • Fax: 248-879-3462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number4301033574
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301033020
License Number StateMI

VIII. Authorized Official

Name: SARALA RAVIKANT
Title or Position: PRESIDENT
Credential: MD
Phone: 248-879-8080