Provider Demographics
NPI:1245417617
Name:RAMA SOOD
Entity Type:Organization
Organization Name:RAMA SOOD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-882-2962
Mailing Address - Street 1:5300 HARROUN RD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-2182
Mailing Address - Country:US
Mailing Address - Phone:419-882-2962
Mailing Address - Fax:419-885-2874
Practice Address - Street 1:5300 HARROUN RD
Practice Address - Street 2:SUITE 208
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2182
Practice Address - Country:US
Practice Address - Phone:419-882-2962
Practice Address - Fax:419-885-2874
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0364467Medicaid