Provider Demographics
NPI:1639362247
Name:RAMANATHER SIRITHARA, M.D., P.A.
Entity Type:Organization
Organization Name:RAMANATHER SIRITHARA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMANATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRITHARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-350-3245
Mailing Address - Street 1:10845 PHILADELPHIA RD
Mailing Address - Street 2:
Mailing Address - City:WHITE MARSH
Mailing Address - State:MD
Mailing Address - Zip Code:21162-1717
Mailing Address - Country:US
Mailing Address - Phone:410-335-0008
Mailing Address - Fax:410-335-3113
Practice Address - Street 1:3001 HANOVER ST
Practice Address - Street 2:SUITE 334
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-1233
Practice Address - Country:US
Practice Address - Phone:410-350-3245
Practice Address - Fax:410-350-3050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0017752207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GADS2753OtherRAILROAD MEDICARE
MD232422OtherMEDICARE
DCT679 0001OtherCAREFIRST DC
MD7610ROtherCAREFIRST MARYLAND
GADS2753OtherRAILROAD MEDICARE