Provider Demographics
NPI:1003846163
Name:RAM, RANGANATHAN
Entity Type:Individual
Prefix:DR
First Name:RANGANATHAN
Middle Name:
Last Name:RAM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W 10TH ST
Mailing Address - Street 2:CONNECTIONS CSP INC
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-1422
Mailing Address - Country:US
Mailing Address - Phone:302-250-2023
Mailing Address - Fax:
Practice Address - Street 1:410 FOULK RD STE 106
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3835
Practice Address - Country:US
Practice Address - Phone:302-762-2285
Practice Address - Fax:302-762-2286
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100070132084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE012466D77Medicare ID - Type Unspecified