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General NPI Number Information
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NPI Number | 1063426922
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Entity Type | Individual
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Provider Name | JAMBUNATHAN RAMANATHAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 4646 JOHN R JOHN.D.DINGELL VA
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-576-1000
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Fax | 313-576-1000
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Provider Business Mailing Address
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Address Line | 1183 BRADBURY DR
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City | TROY
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State | MI
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Zip | 48098-6314
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Country | US
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Telephone | 248-267-6558
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Fax | 248-267-6558
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301063102
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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 | 4301063102
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 4301063102
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License Number State | MI
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