Provider Demographics
NPI:1346210960
Name:RAMAIAH, ANITA (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:RAMAIAH
Suffix:
Gender:F
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:PO BOX 18019
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85269-8019
Mailing Address - Country:US
Mailing Address - Phone:480-767-9667
Mailing Address - Fax:480-767-3160
Practice Address - Street 1:12991 N 130TH WAY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85259-3548
Practice Address - Country:US
Practice Address - Phone:480-767-9667
Practice Address - Fax:480-767-3160
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-25
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25196207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ399841-04Medicaid
P2370586OtherAETNA PIN
P2370586OtherAETNA PIN
AZ399841-04Medicaid