=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053393702
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAHESH C KARAMCHANDANI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/17/2005
-----------------------------------------------------
Last Update Date | 11/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3770 CAPITAL AVE SW SUITE A
-----------------------------------------------------
City | BATTLE CREEK
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49015-9411
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-441-1771
-----------------------------------------------------
Fax | 269-441-1773
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 JOHN ST BOX 42
-----------------------------------------------------
City | KALAMAZOO
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49007-5341
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 269-341-8419
-----------------------------------------------------
Fax | 269-341-8743
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208C00000X
-----------------------------------------------------
Taxonomy Name | Colon & Rectal Surgery Physician
-----------------------------------------------------
License Number | MD050945
-----------------------------------------------------
License Number State | MI
-----------------------------------------------------