Provider Demographics
NPI:1336111525
Name:GADDIPATI, RAMAKRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMAKRISHNA
Middle Name:
Last Name:GADDIPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:116R HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2923
Mailing Address - Country:US
Mailing Address - Phone:978-745-0654
Mailing Address - Fax:978-745-7296
Practice Address - Street 1:116 R HIGHLAND AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2923
Practice Address - Country:US
Practice Address - Phone:978-745-0654
Practice Address - Fax:978-745-7296
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA219933207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology