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General NPI Number Information
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NPI Number | 1023633559
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Entity Type | Individual
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Provider Name | KARTHIK S RAMASESHAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 4646 JOHN R ST RM B3249
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City | DETROIT
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State | MI
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Zip | 48201-1916
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Country | US
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Telephone | 248-508-1865
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Fax | 864-602-6559
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Provider Business Mailing Address
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Address Line | 32518 NEW YORK ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48082-2078
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Country | US
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Telephone | 248-508-1865
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Fax | 864-602-6559
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 4301509847
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301509847
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License Number State | MI
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