Provider Demographics
NPI:1164099503
Name:SANTHANAM, RAMALAKSHMI (MD)
Entity Type:Individual
Prefix:
First Name:RAMALAKSHMI
Middle Name:
Last Name:SANTHANAM
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 1:843 FARRAR DRIVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:SC
Mailing Address - Zip Code:29526-8747
Mailing Address - Country:US
Mailing Address - Phone:843-347-9487
Mailing Address - Fax:843-347-9574
Practice Address - Street 1:834 FARRAR DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8747
Practice Address - Country:US
Practice Address - Phone:843-347-9487
Practice Address - Fax:843-347-9574
Is Sole Proprietor?:No
Enumeration Date:2021-06-04
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417540207RN0300X
SC86789207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology