Provider Demographics
NPI:1679700280
Name:MARAHATTA, RAMESH R (MD)
Entity Type:Individual
Prefix:MR
First Name:RAMESH
Middle Name:R
Last Name:MARAHATTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3355 RIVERBEND DR
Mailing Address - Street 2:STE 200
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97477-8800
Mailing Address - Country:US
Mailing Address - Phone:541-868-9233
Mailing Address - Fax:541-868-9606
Practice Address - Street 1:3355 RIVERBEND DR
Practice Address - Street 2:STE 200
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97477-8800
Practice Address - Country:US
Practice Address - Phone:541-868-9233
Practice Address - Fax:541-868-9606
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ORMD175686207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR105482Medicare PIN