Provider Demographics
NPI:1205009891
Name:RAMARAJ, RADHAKRISHNAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RADHAKRISHNAN
Middle Name:
Last Name:RAMARAJ
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 1:710 ERWIN RD
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28334-4522
Mailing Address - Country:US
Mailing Address - Phone:910-304-1212
Mailing Address - Fax:910-292-2627
Practice Address - Street 1:710 ERWIN RD
Practice Address - Street 2:
Practice Address - City:DUNN
Practice Address - State:NC
Practice Address - Zip Code:28334-4522
Practice Address - Country:US
Practice Address - Phone:910-304-1212
Practice Address - Fax:910-292-2627
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2014-01190207UN0901X, 207RI0011X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1205009891OtherBLUE MEDICARE
NC1205009891OtherCIGNA
NC1205009891OtherWELLCARE( MEDICARE ADVANTAGE)
NC1205009891OtherHEALTHY BLUE
NC1205009891OtherMEDCOST
NC1205009891OtherWELLCARE( MEDICAID)
NC1205009891OtherUNITED MEDICARE ADVANTAGE- AARP
NC1205009891Medicaid
NC1205009891OtherVETERANS AFFAIRS
NC1205009891OtherCAROLINA COMPLETE HEALTH( CENTENE)
NC1205009891OtherAETNA
NC1205009891OtherBLUECROSS BLUESHIELD OF NORTH CAROLINA
NC1205009891OtherHUMANA MILITARY
NC1205009891OtherAMERIHEALTH CARITAS
NC1205009891OtherUNITED HEALTHCARE
NC1205009891OtherHUMANA
NC1205009891OtherUNITED HEALTH CARE MEDICARE ADVANTAGE- COMMUNITY
NC1205009891OtherMULTIPLAN
NC1205009891OtherAMBETTER