Provider Demographics
NPI:1851356216
Name:DAVOUDI, RAMIN R (MD)
Entity Type:Individual
Prefix:
First Name:RAMIN
Middle Name:R
Last Name:DAVOUDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:200 MILL ROAD
Mailing Address - Street 2:SUITE 180
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5252
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:676 AQUIDNECK AVE
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5795
Practice Address - Country:US
Practice Address - Phone:401-849-9042
Practice Address - Fax:401-849-7540
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD14023207RC0001X, 207RC0000X
MA220443207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRD90608Medicaid
MA110098891AMedicaid
MA110098891AMedicaid
MA002879602Medicare PIN