Provider Demographics
NPI:1710997853
Name:RAMASWAMY, DEVANHALLI (MD)
Entity Type:Individual
Prefix:
First Name:DEVANHALLI
Middle Name:
Last Name:RAMASWAMY
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 1:21495 RIDGETOP CIR STE 102
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-6512
Mailing Address - Country:US
Mailing Address - Phone:703-433-5000
Mailing Address - Fax:703-444-3921
Practice Address - Street 1:21495 RIDGETOP CIR STE 102
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-6512
Practice Address - Country:US
Practice Address - Phone:703-433-5000
Practice Address - Fax:703-444-3921
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101021655207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6017436Medicaid
VAD09611Medicare UPIN
VA060000589Medicare PIN