Provider Demographics
NPI:1487832473
Name:MUTHULAKSMI RAMESH, M.D., P.C.
Entity Type:Organization
Organization Name:MUTHULAKSMI RAMESH, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:MUTHULAKSMI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:509-627-1088
Mailing Address - Street 1:1950 KEENE RD
Mailing Address - Street 2:BLDG J
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-7751
Mailing Address - Country:US
Mailing Address - Phone:509-627-1088
Mailing Address - Fax:509-783-9148
Practice Address - Street 1:1950 KEENE RD BLDG J
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-7752
Practice Address - Country:US
Practice Address - Phone:509-627-1088
Practice Address - Fax:509-627-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040452207N00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1115658Medicaid
WA1115658Medicaid