Provider Demographics
NPI:1467568485
Name:RAMAIYA, KAMALESH J (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMALESH
Middle Name:J
Last Name:RAMAIYA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8801 HORIZON BLVD NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1533
Mailing Address - Country:US
Mailing Address - Phone:505-828-4923
Mailing Address - Fax:505-213-0103
Practice Address - Street 1:5757 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3566
Practice Address - Country:US
Practice Address - Phone:505-888-5757
Practice Address - Fax:505-213-0103
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2011-11-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2009005095207W00000X
NMMD2011-0677207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM88482774Medicaid
NMP00977423OtherMEDICARE RAILROAD CARRIER PALMETTO GBA
NMP00977423OtherMEDICARE RAILROAD CARRIER PALMETTO GBA