Provider Demographics
NPI:1528400785
Name:ROHATGI, RAM KEVIN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAM
Middle Name:KEVIN
Last Name:ROHATGI
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 CHILDRENS PL
Mailing Address - Street 2:MSC 8208-16-01
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1002
Mailing Address - Country:US
Mailing Address - Phone:314-454-6095
Mailing Address - Fax:314-454-2561
Practice Address - Street 1:1 CHILDRENS PL
Practice Address - Street 2:DIV PED CARDIOLOGY
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1002
Practice Address - Country:US
Practice Address - Phone:314-454-6095
Practice Address - Fax:314-454-2561
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2023-09-26
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Provider Licenses
StateLicense IDTaxonomies
MO2021033891208000000X, 2080P0202X, 2080P0202X
WI731712080P0202X
MN581902080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO500053300Medicaid