Provider Demographics
NPI:1699812990
Name:KAZA, RAMARAO (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMARAO
Middle Name:
Last Name:KAZA
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 1:2312 LEMAY FERRY RD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63125-3127
Mailing Address - Country:US
Mailing Address - Phone:314-894-5419
Mailing Address - Fax:314-845-3540
Practice Address - Street 1:2312 LEMAY FERRY RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-3127
Practice Address - Country:US
Practice Address - Phone:314-894-5419
Practice Address - Fax:314-845-3540
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO35441208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOA78381Medicare UPIN