Provider Demographics
NPI:1326056201
Name:RAMASAMY, SENTHILKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:SENTHILKUMAR
Middle Name:
Last Name:RAMASAMY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 GOLF COURSE RD SE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-4728
Mailing Address - Country:US
Mailing Address - Phone:505-234-1616
Mailing Address - Fax:505-234-1617
Practice Address - Street 1:1101 GOLF COURSE RD SE
Practice Address - Street 2:SUITE 203
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4728
Practice Address - Country:US
Practice Address - Phone:505-234-1616
Practice Address - Fax:505-234-1617
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2003-05522084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM84875OtherPRESBYTERIAN HEALTH PLAN
NM01723049Medicaid
NM1316133580OtherNPI GROUP
NM43027261Medicaid
NMNM009K77OtherBCBS NEW MEXICO
NM1326056201OtherNPI INDIVIDUAL
NMP00094435OtherRAILROAD MEDICARE
NM100521027Medicare PIN
NM1326056201OtherNPI INDIVIDUAL
NM43027261Medicaid