Provider Demographics
NPI:1114175668
Name:RAMESH, GEETHA (MD)
Entity Type:Individual
Prefix:
First Name:GEETHA
Middle Name:
Last Name:RAMESH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GEETHA
Other - Middle Name:
Other - Last Name:DODDAIANAPALYA SOMASHEKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9769
Practice Address - Street 1:818 N CARRIAGE PKWY
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-4500
Practice Address - Country:US
Practice Address - Phone:316-651-2252
Practice Address - Fax:316-651-2314
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-35067207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200741170BMedicaid
KS04-35067OtherSTATE LICENSE
P01276363OtherRR MEDICARE
003719284Medicare PIN