Provider Demographics
NPI:1275533390
Name:RAMAN, MANJULA KANDAA (MD)
Entity Type:Individual
Prefix:MRS
First Name:MANJULA
Middle Name:KANDAA
Last Name:RAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13 ARMAND HAMMER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-5067
Mailing Address - Country:US
Mailing Address - Phone:610-323-3100
Mailing Address - Fax:610-323-7060
Practice Address - Street 1:13 ARMAND HAMMER BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19464-5067
Practice Address - Country:US
Practice Address - Phone:610-323-3100
Practice Address - Fax:610-323-7060
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066391L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001971383Medicaid
PA036333Medicare ID - Type Unspecified