Provider Demographics
NPI:1124012406
Name:RAMSAMOOJ, RAVI (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:RAMSAMOOJ
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 1:206 HASTINGS LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-3324
Mailing Address - Country:US
Mailing Address - Phone:252-335-1083
Mailing Address - Fax:252-335-4030
Practice Address - Street 1:206 HASTINGS LN
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-3324
Practice Address - Country:US
Practice Address - Phone:252-335-1083
Practice Address - Fax:252-335-4030
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA279689OtherANTHEM BLUE CROSS BLUE SH
NC89137K0Medicaid
197180OtherMEDCOST
NCP00391179OtherRAILROAD MEDICARE
NC137K0OtherBLUE CROSS BLUE SHIELD
NC89137K0Medicaid
NCP00391179OtherRAILROAD MEDICARE