Provider Demographics
NPI:1154419463
Name:RANA, KANWAR V (MD)
Entity type:Individual
Prefix:DR
First Name:KANWAR
Middle Name:V
Last Name:RANA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15435 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-9503
Mailing Address - Country:US
Mailing Address - Phone:269-781-7772
Mailing Address - Fax:269-969-8921
Practice Address - Street 1:15435 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-9503
Practice Address - Country:US
Practice Address - Phone:269-781-7772
Practice Address - Fax:269-969-8921
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010602872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIF53481Medicare UPIN
MI0P11880Medicare ID - Type Unspecified