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General NPI Number Information
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NPI Number | 1205842242
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Entity Type | Individual
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Provider Name | LAKSHMANA RAO AYYAGARI M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1165 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-3406
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Country | US
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Telephone | 810-732-5400
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Fax | 810-733-1624
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Provider Business Mailing Address
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Address Line | 1165 S LINDEN RD
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City | FLINT
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State | MI
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Zip | 48532-3406
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Country | US
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Telephone | 810-732-5400
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Fax | 810-733-1624
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 036054745
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 4301106360
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License Number State | MI
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