Provider Demographics
NPI:1417937111
Name:RAMAN, MANIMEKALAI V (MD)
Entity Type:Individual
Prefix:
First Name:MANIMEKALAI
Middle Name:V
Last Name:RAMAN
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 1680
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25717-1680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1301 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3803
Practice Address - Country:US
Practice Address - Phone:304-525-0572
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19091207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000000178441OtherANTHEM
WV001709560OtherMT. STATE
KY64942337Medicaid
WV0081279000Medicaid
OH2059785Medicaid
WV00058430OtherRR MEDICARE
WVWV2815C604Medicare PIN
WV000000178441OtherANTHEM
WV00058430OtherRR MEDICARE
WV001709560OtherMT. STATE
OH2059785Medicaid
WVWV2815AMedicare PIN
WV2018905Medicare PIN