Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 4301104221 | MI |
N | 2080P0202X | Pediatric Cardiologist | 4301104221 | MI |
NPI | 1043411721 |
---|---|
Provider Name | Christopher Ratnasamy |
First Address | Grand Rapids, MI 49503-2560 |
Second Address | Grand Rapids, MI 49503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 14/04/2021 |