Provider Demographics
NPI:1104863885
Name:BATRA, RAM P (MD)
Entity Type:Individual
Prefix:
First Name:RAM
Middle Name:P
Last Name:BATRA
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 1:38172 MEDICAL CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ZEPHYRHILLS
Mailing Address - State:FL
Mailing Address - Zip Code:33540-1380
Mailing Address - Country:US
Mailing Address - Phone:813-783-1859
Mailing Address - Fax:813-782-2271
Practice Address - Street 1:38172 MEDICAL CENTER AVE
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33540-1380
Practice Address - Country:US
Practice Address - Phone:813-783-1859
Practice Address - Fax:813-782-2271
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME42613174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL593429494OtherTAX ID
FL043019600Medicaid
FL593429494OtherTAX ID
FL043019600Medicaid