Basic Information
| Provider Information | |||||||||
| NPI: | 1821197435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAGAPPAN | ||||||||
| FirstName: | RAMANATHAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 E MICHIGAN AVE STE 725 | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489121832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173645599 | ||||||||
| FaxNumber: | 5173645590 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 E MICHIGAN AVE STE 725 | ||||||||
| Address2: | |||||||||
| City: | LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 489121832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173645599 | ||||||||
| FaxNumber: | 5173645590 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 06/06/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | 43149 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 2500031 | 01 | MI | PHYSICIANS HEALTH PLAN | OTHER | 139840 | 01 | MI | GREAT LAKES HEALTH PLAN | OTHER | 1425801 | 05 | MI | MEDICAID | C2100 | 01 | MI | MCARE | OTHER | RN043149 | 01 | MI | BCBS | OTHER | 2570131 | 01 | MI | PHYS HEALTH PLAN FAMILY | OTHER | 1228780003 | 01 | MI | WELLNESS PLAN | OTHER | 201602 | 01 | MI | MCLAREN | OTHER | RN043149 | 01 | MI | BLUE CARE NETWORK | OTHER | 110091891 | 01 | MI | TRAVELERS MEDICARE | OTHER |