NPIMap

Individual provider Active NPI

Ram Gunabalan, MD

  • Internal Medicine Physician
  • Troy, MI
National Provider Identifier
1710019955
Registry record updated Sep 13, 2011
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(3) exclusion effective Aug 20, 2017.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301032784 Issued in MI
Practice address
363 W Big Beaver Rd
Suite 200
Troy, MI 48084-5220
Phone
(248) 619-9771
Fax
(248) 583-8969
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301032784 MI Primary

Addresses

Primary practice location

363 W Big Beaver Rd
Suite 200
Troy, MI 48084-5220

Mailing address

30781 Stephenson Hwy
Madison HTS, MI 48071-1618
Phone (248) 583-8922

Other identifiers 2

IdentifierTypeStateIssuer
LICENSE NUMBEROtherMI4301032784
BCBSM PIN NUMBEROtherMI0827216

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301032784MIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mi Physicians PLLC PastSince Aug 1, 2010 Accepting new patients
Michigan Visiting Physicians PC PastSince Apr 15, 2009 Accepting new patients
Madison Community Hospital Inc PastSince May 1, 1997 Accepting new patients
Freedom Supplies Inc PastSince Dec 15, 2003 Accepting new patients
Madison Medical Center PastSince Jul 1, 1999 Accepting new patients
Meridian Medical PLLC PastSince Mar 15, 2009 Accepting new patients
Bio-Magnetic Resonance Inc PastSince Feb 4, 2004 Accepting new patients
Geriatric Psychiatric Services PLLC PastSince Feb 1, 2009 Accepting new patients
Michigan Bio Tech Partners, LLC PastSince Jul 1, 2004 Accepting new patients
Sterling Medical Clinic PLLC PastSince Sep 28, 2010 Accepting new patients

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1710019955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30781 STEPHENSON HWY",
            "city": "MADISON HTS",
            "state": "MI",
            "postal_code": "480711618",
            "telephone_number": "248-583-8922",
            "fax_number": "248-583-8969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 W BIG BEAVER RD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480845220",
            "telephone_number": "248-619-9771",
            "fax_number": "248-583-8969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNABALAN",
        "first_name": "RAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301032784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "4301032784",
            "identifier": "LICENSE NUMBER",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "0827216",
            "identifier": "BCBSM PIN NUMBER",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.