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General NPI Number Information
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NPI Number | 1811996333
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Entity Type | Individual
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Provider Name | RANI THANGAM POTTI M.D. M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4215 S BEECH DALY ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48125-1567
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Country | US
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Telephone | 313-278-7750
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Fax | 313-278-8729
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Provider Business Mailing Address
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Address Line | 18249 CASCADE DR
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City | NORTHVILLE
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State | MI
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Zip | 48167-3288
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Country | US
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Telephone | 248-596-9580
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Fax | 313-278-8729
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301058831
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License Number State | MI
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