Provider Demographics
NPI:1366651531
Name:BIKKASANI RAM HELLSTERN AND CHANDRUPATLA MDPA
Entity Type:Organization
Organization Name:BIKKASANI RAM HELLSTERN AND CHANDRUPATLA MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:RAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-563-2450
Mailing Address - Street 1:6410 W GULF TO LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429
Mailing Address - Country:US
Mailing Address - Phone:352-563-2450
Mailing Address - Fax:
Practice Address - Street 1:6410 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429
Practice Address - Country:US
Practice Address - Phone:352-563-2450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIKKASANI RAM HELLSTERN AND CHANDRUPATLA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-22
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty