Provider Demographics
NPI:1093779977
Name:SIRITHARA, RAMANATHER (MD)
Entity Type:Individual
Prefix:
First Name:RAMANATHER
Middle Name:
Last Name:SIRITHARA
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 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-3113
Practice Address - Street 1:3001 S HANOVER ST
Practice Address - Street 2:SUITE 334
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-335-3245
Practice Address - Fax:410-350-3050
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0017752207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD7610OtherMEDICARE
MD184371100OtherMEDICAL ASSISTANCE
DCT679 0001OtherCAREFIRST
606744600OtherDEPT. OF LABOR
MD232409YF7QOtherMEDICARE
MD761R 36319001OtherCAREFIRST
GAP01011585OtherRAILROAD MEDICARE