Provider Demographics
NPI:1922167790
Name:SAMAVEDY, RAMANUJAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMANUJAN
Middle Name:
Last Name:SAMAVEDY
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 1:1311 DOWELL SPRINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2454
Mailing Address - Country:US
Mailing Address - Phone:865-588-5121
Mailing Address - Fax:
Practice Address - Street 1:1311 DOWELL SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2454
Practice Address - Country:US
Practice Address - Phone:865-588-5121
Practice Address - Fax:865-588-2126
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2022-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047807A207R00000X
TN43555207RG0100X
WI49589207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
006773844Medicare PIN
001065003Medicare PIN
006452540Medicare PIN