Provider Demographics
NPI:1962499806
Name:RAMADOSS, UMASANKAR (MD)
Entity Type:Individual
Prefix:
First Name:UMASANKAR
Middle Name:
Last Name:RAMADOSS
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 1:1705 E BROADWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-5852
Mailing Address - Country:US
Mailing Address - Phone:573-874-7800
Mailing Address - Fax:573-443-3627
Practice Address - Street 1:1705 E BROADWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5852
Practice Address - Country:US
Practice Address - Phone:573-874-7800
Practice Address - Fax:573-443-3627
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005026871207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207244302Medicaid
MOMA1231011Medicare PIN
H58907Medicare UPIN
MO207244302Medicaid
MO935422700Medicare PIN