Provider Demographics
NPI:1093767725
Name:DANRAD, RAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:
Last Name:DANRAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 TULANE AVE
Mailing Address - Street 2:ROOM 353
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2865
Mailing Address - Country:US
Mailing Address - Phone:504-568-4647
Mailing Address - Fax:504-568-8955
Practice Address - Street 1:1542 TULANE AVE
Practice Address - Street 2:ROOM 353
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2865
Practice Address - Country:US
Practice Address - Phone:504-568-4647
Practice Address - Fax:504-568-8955
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.2052442085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOI53705Medicare UPIN
MO201068103Medicaid
MO957041552Medicare ID - Type Unspecified