Provider Demographics
NPI:1073511341
Name:RAMESH, SHANTI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHANTI
Middle Name:
Last Name:RAMESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 SINCLAIR LN
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-2029
Mailing Address - Country:US
Mailing Address - Phone:410-558-4888
Mailing Address - Fax:410-327-1693
Practice Address - Street 1:2323 ORLEANS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-1020
Practice Address - Country:US
Practice Address - Phone:410-558-4747
Practice Address - Fax:410-732-0185
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD035082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D76315Medicare UPIN
S732Y793Medicare ID - Type Unspecified