Provider Demographics
NPI:1629264510
Name:ATHIPPALAYAM CHELLAMUTHU, RAMESHKUMAR (MD,)
Entity Type:Individual
Prefix:DR
First Name:RAMESHKUMAR
Middle Name:
Last Name:ATHIPPALAYAM CHELLAMUTHU
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 1:1026 GOODYEAR AVE STE 302B
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1102
Mailing Address - Country:US
Mailing Address - Phone:256-485-0899
Mailing Address - Fax:866-265-9563
Practice Address - Street 1:1026 GOODYEAR AVE STE 302B
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1102
Practice Address - Country:US
Practice Address - Phone:256-485-0899
Practice Address - Fax:866-265-9563
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL32348207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL32348OtherLICENSE