Provider Demographics
NPI:1346464849
Name:RAMA, SREEDHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SREEDHAR
Middle Name:
Last Name:RAMA
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 1:5820 GOLDEN BEAR DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-2950
Mailing Address - Country:US
Mailing Address - Phone:814-462-5095
Mailing Address - Fax:484-493-9908
Practice Address - Street 1:2316 E MEYER BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132
Practice Address - Country:US
Practice Address - Phone:816-276-7650
Practice Address - Fax:816-276-7090
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017040910208M00000X, 207R00000X
PAMD430486208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1018828490001Medicaid
PAMD430486OtherSTATE LICENSE
PAMD430486OtherSTATE LICENSE
PA110055Q24Medicare PIN