Provider Demographics
NPI:1538190541
Name:RANGWANI, SUNIL RAMCHAND (MD)
Entity type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:RAMCHAND
Last Name:RANGWANI
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 1:317 E WARWICK DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1085
Mailing Address - Country:US
Mailing Address - Phone:989-463-2779
Mailing Address - Fax:989-463-2064
Practice Address - Street 1:317 E WARWICK DR
Practice Address - Street 2:SUITE B
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1085
Practice Address - Country:US
Practice Address - Phone:989-463-2779
Practice Address - Fax:989-463-2064
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010661532084A0401X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2602900162OtherBLUE CROSS BLUE SHIELD
MI260044994OtherRR MEDICARE
MI4226356Medicaid
MI4226356Medicaid
MI260044994OtherRR MEDICARE