Provider Demographics
NPI:1326032301
Name:RAMPRASAD, KRISH (MD)
Entity Type:Individual
Prefix:
First Name:KRISH
Middle Name:
Last Name:RAMPRASAD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3247
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47731-3247
Mailing Address - Country:US
Mailing Address - Phone:800-467-2392
Mailing Address - Fax:812-471-6650
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-447-2517
Practice Address - Fax:610-956-0069
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037810L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0745815Medicaid
PA0745815Medicaid
PA021075Medicare PIN