Provider Demographics
NPI:1225233430
Name:CHANDRASHEKARAN, RAMA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMA
Middle Name:
Last Name:CHANDRASHEKARAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:RAMA
Other - Middle Name:
Other - Last Name:RAGHUNATHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:215 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:KY
Mailing Address - Zip Code:41071-2203
Mailing Address - Country:US
Mailing Address - Phone:859-655-6100
Mailing Address - Fax:
Practice Address - Street 1:7607 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-2689
Practice Address - Country:US
Practice Address - Phone:859-655-6100
Practice Address - Fax:859-282-8611
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-096164208000000X
KY46809208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3096224Medicaid
KY7100291840Medicaid
IN201140440Medicaid
OH3096224Medicaid