Provider Demographics
NPI:1114973526
Name:RAMACHANDRAN, NITYA (MD)
Entity Type:Individual
Prefix:
First Name:NITYA
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17810 MEETING HOUSE RD
Mailing Address - Street 2:STE 150
Mailing Address - City:SANDY SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20860-1047
Mailing Address - Country:US
Mailing Address - Phone:240-389-1722
Mailing Address - Fax:
Practice Address - Street 1:17810 MEETING HOUSE RD
Practice Address - Street 2:SUITE 150
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1038
Practice Address - Country:US
Practice Address - Phone:240-389-1722
Practice Address - Fax:240-389-1746
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-26
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0054328208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1206021OtherUNITED HEALTHCARE
2444110OtherAETNA HMO
MD542307400Medicaid
MD292867OtherMAMSI
7462166OtherAETNA PPO
MD683204100Medicaid
5518021001OtherCIGNA
MD61111902OtherBC/BS