Provider Demographics
NPI:1093731226
Name:SURESH, RAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMA
Middle Name:
Last Name:SURESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:800-647-2098
Mailing Address - Fax:314-362-3192
Practice Address - Street 1:10 BARNES WEST DR
Practice Address - Street 2:DIV IM MEDICAL ONCOLOGY, MOB #2
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6287
Practice Address - Country:US
Practice Address - Phone:800-647-2098
Practice Address - Fax:314-362-3192
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2024-04-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO115986207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209063502Medicaid
MO209063502Medicaid
MO918160183Medicare PIN
IL$$$$$$$$$Medicaid