RAVI K SHASTRI (NPI# 1790931715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790931715 |
Entity Type | Individual |
Full Name | RAVI K SHASTRI |
Credential | M.D. |
Practice Address |
2122 Health Dr Sw Ste 160 Wyoming MI 49519-9402 |
Mailing Address |
5900 Byron Center Ave Sw Medical Administration Wyoming MI 49519-9606 |
Practice Telephone | 6162525790 |
Practice Fax Number | 6162525793 |
Mailing Telephone | 6162523243 |
Mailing Fax Number | 6162520260 |
Enumeration Date | 2008-08-10 |
Last Update Date | 2018-03-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2085N0700X |
Radiology Specialization: Neuroradiology |
4301103078 | MI | Allopathic & Osteopathic Physicians |
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
4301103078 | MI | Allopathic & Osteopathic Physicians |
N | 208600000X | Surgery | R70528 | AZ | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1500 E Medical Center Dr, B1 Floor University Hospital Rec C, Ann Arbor, MI 481095030 | 7349364566 |
Street Address |
2122 HEALTH DR SW STE 160 |
City | WYOMING |
State | MI |
Zip Code | 49519-9402 |
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 | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659509701 | Mark T Tierney | Radiology | 5900 Byron Center Ave Sw, Wyoming, MI 49519 | 2009-06-29 |
1326264763 | Matthew August Tiede | Radiology | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9686 | 2007-04-17 |
1215031828 | Janan Abbas Alkilidar | Radiology | 5900 Byron Center Ave Sw, Wyoming, MI 49519 | 2006-09-12 |
1972555308 | Mark Traill | Radiology | 5900 Byron Center Ave Sw, Wyoming, MI 49519 | 2006-05-16 |
1326012634 | Guillermo R Sanchez | Radiology | 5900 Byron Center Ave Sw, Wyoming, MI 49519-9606 | 2006-02-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245855667 | Joshua Boulter | Radiology | 2250 Providence Drive, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-11 |
1679197693 | Shyam Amin | Radiology | Academic Internal Medicine 2 2250 Providence Dr, 3pmb Suite #301, Southfield, MI 48075-4818 | 2020-06-05 |
1871116509 | Anthony Diebes | Radiology | 16001 W 9 Mile Rd Bldg 4th, Southfield, MI 48075-4818 | 2020-05-28 |
1548823800 | Alexander Paul Kaechele | Radiology | 16001 West 9 Mile Road, Suite #416, Southfield, MI 48075-4818 | 2019-04-22 |
1790246627 | Genesis Healthcare | Radiology | 8560 N Silvery Ln Ste 101, Dearborn Heights, MI 48127-4516 | 2019-03-25 |
1023572831 | Proscan Imaging Southfield Pllc | Radiology | 29877 Telegraph Rd # 11, Southfield, MI 48034-1332 | 2019-01-25 |
1295204253 | Easy Imaging, LLC | Radiology | 16100 19 Mile Rd Ste X, Clinton Township, MI 48038-1148 | 2018-11-20 |
1205304888 | Ascension Medical Group Genesys | Radiology | 1096 S Belsay Rd Ste J, Burton, MI 48509-1948 | 2018-11-13 |
1336626696 | Quantum Medical Radiology of California, P.C. | Radiology | 1625 Bear Creek Ln Unit O, Petoskey, MI 49770-8378 | 2018-07-19 |
1376072488 | Cambridge Institute of Minimally Invasive Therapies Pllc | Radiology | 2007 E 14 Mile Rd, Sterling Heights, MI 48310-5905 | 2017-06-12 |
Find all providers with the same taxonomy |
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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.