Provider Demographics
NPI:1205820339
Name:M.RAMMOHAN MD INC
Entity Type:Organization
Organization Name:M.RAMMOHAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUTHURAMALINGAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMMOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-394-8844
Mailing Address - Street 1:1700 E MARKET ST
Mailing Address - Street 2:SUITE # 108
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483-6625
Mailing Address - Country:US
Mailing Address - Phone:330-394-8844
Mailing Address - Fax:330-394-5160
Practice Address - Street 1:1700 E MARKET ST
Practice Address - Street 2:SUITE # 108
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483-6625
Practice Address - Country:US
Practice Address - Phone:330-394-8844
Practice Address - Fax:330-394-5160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH39188207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0310667Medicaid
OH1041513OtherHIPPA
OH0310667Medicaid
OH1041513OtherHIPPA