Provider Demographics
NPI:1114969268
Name:SAPASETTY, RAM ANAND (MD)
Entity Type:Individual
Prefix:DR
First Name:RAM
Middle Name:ANAND
Last Name:SAPASETTY
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 1:608A AIRPORT ROAD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504
Mailing Address - Country:US
Mailing Address - Phone:252-523-8512
Mailing Address - Fax:252-317-2096
Practice Address - Street 1:608A AIRPORT ROAD
Practice Address - Street 2:
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28504
Practice Address - Country:US
Practice Address - Phone:252-523-8512
Practice Address - Fax:252-317-2096
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700743207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10740OtherBC/BS-NC INDIVIDUAL #
NC8910740Medicaid
NC2190717OtherUNITED HEALTH CARE
NCP00054284Medicare ID - Type UnspecifiedRAILROAD MEDICARE
NC8910740Medicaid
NC2246383GMedicare ID - Type UnspecifiedMEDICARE INDIVIDUAL #