Provider Demographics
NPI:1932297991
Name:DEV-RAMAN, SIMRET (MD)
Entity Type:Individual
Prefix:
First Name:SIMRET
Middle Name:
Last Name:DEV-RAMAN
Suffix:
Gender:F
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:PO BOX 602658
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2658
Mailing Address - Country:US
Mailing Address - Phone:336-716-2011
Mailing Address - Fax:
Practice Address - Street 1:200 W PARK CIR
Practice Address - Street 2:SUITE C, WILKES REGIONAL FAMILY MEDICINE
Practice Address - City:NORTH WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3541
Practice Address - Country:US
Practice Address - Phone:336-903-7870
Practice Address - Fax:336-903-7871
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-01306207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5910229Medicaid
NC5910229Medicaid
NC2023018Medicare PIN