Basic Information
Provider Information
NPI: 1285125369
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMACHANDRAN
FirstName: RITHAMBARA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3621 S STATE ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481081633
CountryCode: US
TelephoneNumber: 7346475299
FaxNumber:  
Practice Location
Address1: 1000 WALL ST
Address2:  
City: ANN ARBOR
State: MI
PostalCode: 481051912
CountryCode: US
TelephoneNumber: 7347644190
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/23/2018
LastUpdateDate: 07/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000X4301506263MIY Allopathic & Osteopathic PhysiciansOphthalmology 

No ID Information.


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