Provider Demographics
NPI:1356323869
Name:RAMCHANDANI, GEETA SUSHIL (MD)
Entity Type:Individual
Prefix:DR
First Name:GEETA
Middle Name:SUSHIL
Last Name:RAMCHANDANI
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 1:5213 S ALSTON AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4430
Mailing Address - Country:US
Mailing Address - Phone:919-620-4917
Mailing Address - Fax:919-620-4921
Practice Address - Street 1:1901 HILLANDALE RD
Practice Address - Street 2:SUITE D
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2664
Practice Address - Country:US
Practice Address - Phone:919-383-4355
Practice Address - Fax:919-383-8791
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00041685207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA189140OtherLABOR & INDUSTRIES
WA0836RAOtherBLUE SHIELD
WAP00322876OtherMEDICARE RAILROAD
WA8327223Medicaid
WAG8808627Medicare PIN
WA0836RAOtherBLUE SHIELD
WAG8808625Medicare PIN