Provider Demographics
NPI:1144254913
Name:KARETI, DAS L (MD)
Entity type:Individual
Prefix:DR
First Name:DAS
Middle Name:L
Last Name:KARETI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1318
Mailing Address - Country:US
Mailing Address - Phone:248-650-9100
Mailing Address - Fax:248-650-5141
Practice Address - Street 1:963 OAKWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1318
Practice Address - Country:US
Practice Address - Phone:248-650-9100
Practice Address - Fax:248-650-5141
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43014057332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3096687Medicaid
0637499OtherBLUE CROSS
101574OtherGREAT LAKES
F45577OtherHAP
MI3096687Medicaid
OP16380Medicare ID - Type Unspecified