Provider Demographics
NPI:1609884873
Name:RAMASWAMY, CHAKRAVARTHI RAGHAVAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAKRAVARTHI
Middle Name:RAGHAVAN
Last Name:RAMASWAMY
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 1:5775 N MEADOWS DR STE D
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-7300
Mailing Address - Country:US
Mailing Address - Phone:614-224-4200
Mailing Address - Fax:614-224-4207
Practice Address - Street 1:5775 N MEADOWS DR STE D
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-7300
Practice Address - Country:US
Practice Address - Phone:614-224-4200
Practice Address - Fax:614-224-4207
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.078066207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2186772Medicaid
OH35.078066OtherSTATE MEDICAL LICENSE
OH35.078066OtherSTATE MEDICAL LICENSE
OH2186772Medicaid
OHRA4020381Medicare PIN