Provider Demographics
NPI:1508110032
Name:RAMESH C TANDON MD PLLC
Entity Type:Organization
Organization Name:RAMESH C TANDON MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:C
Authorized Official - Last Name:TANDON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-788-4944
Mailing Address - Street 1:PO BOX 10889
Mailing Address - Street 2:
Mailing Address - City:FORT MOHAVE
Mailing Address - State:AZ
Mailing Address - Zip Code:86427-0889
Mailing Address - Country:US
Mailing Address - Phone:928-788-4944
Mailing Address - Fax:928-788-3900
Practice Address - Street 1:1520 E HAMMER LN
Practice Address - Street 2:SUITE 105
Practice Address - City:FORT MOHAVE
Practice Address - State:AZ
Practice Address - Zip Code:86426-6664
Practice Address - Country:US
Practice Address - Phone:928-788-4944
Practice Address - Fax:928-788-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty