DR. YAGNARAM RAVICHANDRAN (NPI# 1457774788) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457774788 |
| Entity Type | Individual |
| Full Name | DR. YAGNARAM RAVICHANDRAN |
| Credential | MD |
| Practice Address |
3901 Beaubien St Detroit MI 48201-2119 |
| Mailing Address |
1 Childrens Plz Dayton OH 45404-1873 |
| Practice Telephone | 3137455205 |
| Mailing Telephone | 9376413000 |
| Enumeration Date | 2014-01-22 |
| Last Update Date | 2020-10-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0204X |
Pediatrics Specialization: Pediatric Emergency Medicine |
35.133321 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0343550 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Childrens Plz, Dayton, OH 454041873 | 3477419680 | |
| 3333 W Tech Rd, Miamisburg, OH 453420955 | 9376413000 | |
| 445 Lenox Rd, Msc 49, Brooklyn, NY 112032017 | 7182702978 |
| Street Address |
3901 BEAUBIEN ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151238 | Mark Campbell | Nurse Anesthetist, Certified Registered | 3901 Beaubien St, Detroit, MI 48201-2119 | 2005-08-18 |
| 1164037735 | Mamdouh Dakhel A Alahmadi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-09-10 |
| 1801407119 | Samantha Mulkiten | Nurse Practitioner | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-08-11 |
| 1346864550 | Mariane Tomiyoshi Asato | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-06-03 |
| 1629691613 | Abigail Marie Troy | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-05-25 |
| 1235750373 | Katherine Marie Obudzinski | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2196 | 2020-04-29 |
| 1548880073 | Sara Mercedes Evans | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1619597069 | Zahur Fatima Sallman | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-24 |
| 1154941706 | Saira Tariq | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
| 1063032688 | Michael Allen Finkel | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St, Detroit, MI 48201-2119 | 2020-04-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 2080P0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Emergency Medicine |
| A pediatrician who has special qualifications to manage emergencies in infants and children. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417985615 | Stephen Robert Knazik | Pediatrics | 3901 Beaubien Emergency Dept - Main Building, Childrens Hospital of Mi, Detroit, MI 48201 | 2006-06-28 |
| 1316116486 | Nisrine El Chami | Pediatrics | 3901 Beaubien St, Division of Pediatric Emergency Medicine, Detroit, MI 48201-2119 | 2008-02-22 |
| 1326238924 | Katherine Anne Hebert | Pediatrics | 3901 Beaubien St, Detroit, MI 48201-2119 | 2007-07-30 |
| 1912071424 | Julia Lynn Hays | Pediatrics | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2006-11-17 |
| 1447287545 | Indira Onwuzurike | Pediatrics | 3901 Beaubien St, Detroit, MI 48201 | 2006-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861913030 | Ashima Goyal | Pediatrics | 3535 W 13 Mile, South Clinic, Royal Oak, MI 48073 | 2017-06-28 |
| 1598296022 | Elizabeth Marie Budnik | Pediatrics | 1500 E Medical Center Dr, Ann Arbor, MI 48109-5000 | 2017-03-26 |
| 1558817205 | Zina Alhaddad | Pediatrics | 100 Michigan St Ne # Mc13, Grand Rapids, MI 49503-2560 | 2016-08-31 |
| 1316342082 | Dhritiman Gurkha | Pediatrics | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2014-10-23 |
| 1790103737 | Terry L Barrett | Pediatrics | 1500 E Sherman Blvd, Muskegon, MI 49444-1849 | 2014-04-06 |
| 1891904462 | Kelly Anne Levasseur | Pediatrics | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2007-05-21 |
| 1528187762 | University Children 's Urgent Care | Pediatrics | 989 University Dr, Suite 101, Pontiac, MI 48342-1885 | 2007-03-28 |
| 1609907294 | Laura Maria Moody | Pediatrics | 19401 Hubbard Dr, Dearborn, MI 48126-2641 | 2007-03-08 |
| 1467512871 | Maria D. Dorsch | Pediatrics | Henry Ford Health System, 19401 Hubbard Drive, Dearborn, MI 48126 | 2006-12-08 |
| 1205805249 | Vijay Bhardwaj | Pediatrics | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2006-03-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.