Provider Demographics
NPI:1598813016
Name:KALYANARAMAN, VENKATARAMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VENKATARAMAN
Middle Name:
Last Name:KALYANARAMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 STEEPLECHASE RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-5875
Mailing Address - Country:US
Mailing Address - Phone:405-285-5793
Mailing Address - Fax:
Practice Address - Street 1:920 STANTON L YOUNG BLVD # 1345
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5020
Practice Address - Country:US
Practice Address - Phone:405-271-5896
Practice Address - Fax:405-271-7522
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20440207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism