1114973526 NPI number — NITYA RAMACHANDRAN M.D.

Table of content: NITYA RAMACHANDRAN M.D. (NPI 1114973526)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114973526 NPI number — NITYA RAMACHANDRAN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RAMACHANDRAN
Provider First Name:
NITYA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114973526
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17810 MEETING HOUSE RD
Provider Second Line Business Mailing Address:
STE 150
Provider Business Mailing Address City Name:
SANDY SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20860-1047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-389-1722
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
17810 MEETING HOUSE RD
Provider Second Line Business Practice Location Address:
SUITE 150
Provider Business Practice Location Address City Name:
SANDY SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20860-1038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
240-389-1722
Provider Business Practice Location Address Fax Number:
240-389-1746
Provider Enumeration Date:
05/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  D0054328 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1206021 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2444110 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 542307400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 292867 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 7462166 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 683204100 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5518021001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 61111902 . This is a "BC/BS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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