Provider Demographics
NPI:1063493542
Name:UNNI, RAMAKRISHNAN P (MD)
Entity Type:Individual
Prefix:
First Name:RAMAKRISHNAN
Middle Name:P
Last Name:UNNI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:P.
Other - Middle Name:R
Other - Last Name:UNNI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PC
Mailing Address - Street 1:400 WEST 84TH DR.
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410
Mailing Address - Country:US
Mailing Address - Phone:219-769-8641
Mailing Address - Fax:219-769-2280
Practice Address - Street 1:400 WEST 84TH DR.
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410
Practice Address - Country:US
Practice Address - Phone:219-769-8641
Practice Address - Fax:219-769-2280
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026587A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0091108094OtherBLUE SHIELD OF ILLINOIS
IN100158110AMedicaid
IN457160AMedicare PIN
INE05524Medicare UPIN