Provider Demographics
NPI:1689636482
Name:NAGARAJAN, RAMARATHINAM (MD PHD)
Entity Type:Individual
Prefix:
First Name:RAMARATHINAM
Middle Name:
Last Name:NAGARAJAN
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 NICOLLET MALL
Mailing Address - Street 2:221
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402
Mailing Address - Country:US
Mailing Address - Phone:612-339-0807
Mailing Address - Fax:612-339-1854
Practice Address - Street 1:825 NICOLLET MALL
Practice Address - Street 2:221
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402
Practice Address - Country:US
Practice Address - Phone:612-339-0807
Practice Address - Fax:612-339-1854
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN42705207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN882900400OtherMHCP
88DG9NAOtherBCBSBP