Provider Demographics
NPI:1275652117
Name:K.C. RAMESHM MD,P.C.
Entity Type:Organization
Organization Name:K.C. RAMESHM MD,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KALLAMBELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-267-2541
Mailing Address - Street 1:225 S MIDLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-1629
Mailing Address - Country:US
Mailing Address - Phone:770-267-2541
Mailing Address - Fax:770-267-3278
Practice Address - Street 1:225 S MIDLAND AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-1629
Practice Address - Country:US
Practice Address - Phone:770-267-2541
Practice Address - Fax:770-267-3278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE51531Medicare UPIN