SARAT CHANDRA KHANDAVALLI (NPI# 1295996916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295996916 |
| Entity Type | Individual |
| Full Name | SARAT CHANDRA KHANDAVALLI |
| Credential | M.D. |
| Practice Address |
5900 Byron Center Ave Sw Wyoming MI 49519-9606 |
| Mailing Address |
Po Box 1629 Lima OH 45802-1629 |
| Practice Telephone | 6162527166 |
| Mailing Telephone | 8773784293 |
| Mailing Fax Number | 4192232726 |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2020-06-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
4301097445 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 11295996916 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 550 Peachtree St Ne, Atlanta, GA 30308 | 4046861900 |
| Street Address |
5900 BYRON CENTER AVE SW |
| City | WYOMING |
| State | MI |
| Zip Code | 49519-9606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760484869 | Anita Irene Charochak | Internal Medicine | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2005-06-02 |
| 1912504283 | Jacalyn Kaiser | Occupational Therapist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-10-08 |
| 1659987196 | David Paul Mandziara | Specialist/Technologist, Other | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2020-09-21 |
| 1265048847 | Bella Baazov | Occupational Therapist | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-09-19 |
| 1548889504 | Maurice Anthony Marshall | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-10 |
| 1619596814 | Tyler Ledy | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2020-04-09 |
| 1427677475 | James Darin Chessrown | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-09 |
| 1285263533 | Matthew Michael Gibbs | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-07 |
| 1427687755 | Molly Magen | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-07 |
| 1316576804 | Lindsay Grace Schichtel | Student in an Organized Health Care Education/Training Program | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2020-04-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609364009 | Alexandra K Hylen | Dentist | 4489 Byron Center Ave Sw Ste A, Wyoming, MI 49519 | 2018-05-01 |
| 1962925685 | Nicole Lee Kolasa | Rehabilitation Counselor | 2038 Melvin St. Sw, Wyoming, MI 49519 | 2017-07-25 |
| 1720534472 | Michael Ash | Rehabilitation Practitioner | 1870 36th Street, Wyoming, MI 49519 | 2016-08-31 |
| 1891248993 | Kayleigh Saucier | Family Medicine | 5900 Byron Center Avenue Se, Wyoming, MI 49519 | 2016-07-26 |
| 1093112799 | Wmro LLC | Radiology | 5950 Metro Way, Wyoming, MI 49519 | 2014-11-24 |
| 1033547658 | Maranda Catherine Gary | Nurse Practitioner | 2122 Health Drive, Wyoming, MI 49519 | 2013-10-16 |
| 1144657800 | Diana Ro | Psychologist | 4211 Parkway Place Sw, #100, Wyoming, MI 49519 | 2013-09-26 |
| 1386077873 | Lindsey Elizabeth Chorney | Nurse Practitioner | 2122 Health Drive Sw, Suite 133, Wyoming, MI 49519 | 2013-08-20 |
| 1124377163 | Vision and Sensory Center of Michigan LLC | Optometrist | 4467 Byron Center Ave., Wyoming, MI 49519 | 2012-09-06 |
| 1881940203 | Judah | Durable Medical Equipment & Medical Supplies | 2975 Waterchase Way Sw Suite 307, Wyoming, MI 49519 | 2012-08-03 |
| Find all providers in zip 49519 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902251499 | Andrew Francis Martowski | Pathology | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2016-05-03 |
| 1467468827 | Raj Neale Hari | Pathology | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2006-07-31 |
| 1336182542 | Metropolitan Hospital | Pathology | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093323966 | Khairya Fatouh | Pathology | 22101 Morros Road, Pathology Department, Detroit, Detroit, MI 48236 | 2020-07-16 |
| 1942756234 | Ahmed Alrajjal | Pathology | 459 Calvin Avenue, Grosse Pointe Farms, MI 48236-3236 | 2016-08-28 |
| 1649630435 | Barry Dewitt | Pathology | 11345 Greenview Dr, Fenton, MI 48430-2591 | 2016-03-07 |
| 1922467919 | Wilford E. Maldonado | Pathology | 4722 Huron Hill Dr, Okemos, MI 48864-2052 | 2016-02-18 |
| 1144636895 | Ramya Gadde | Pathology | 2799 W.grand Boulevard,henry Ford Hospital, Detroit, MI 48202-2608 | 2014-07-02 |
| 1710329206 | Yulei Shen | Pathology | 1546 Brentwood Dr, Troy, MI 48098-2713 | 2013-07-24 |
| 1437596046 | John P Sherbeck | Pathology | 5305 East Huron River Drive, Ann Arbor, MI 48106 | 2013-05-23 |
| 1942552336 | Kusum Kumar | Pathology | 3885 Highwood Pl, Okemos, MI 48864-3790 | 2012-10-09 |
| 1073864898 | Karel Kithier | Pathology | 5022 Temple Drive, Sterling Heights, MI 48310-4067 | 2012-09-20 |
| 1306191085 | Nathan Stepanek Shaller | Pathology | 1301 Catherine Street, Ann Arbor, MI 48109-5602 | 2012-07-18 |
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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.