Provider Demographics
NPI:1013988807
Name:RAMAN, SHANKAR (MD,MPH)
Entity Type:Individual
Prefix:
First Name:SHANKAR
Middle Name:
Last Name:RAMAN
Suffix:
Gender:M
Credentials:MD,MPH
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 9536
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-9536
Mailing Address - Country:US
Mailing Address - Phone:661-873-4758
Mailing Address - Fax:661-410-3222
Practice Address - Street 1:8200 STOCKDALE HWY STE M10-173
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93311-1091
Practice Address - Country:US
Practice Address - Phone:661-632-6963
Practice Address - Fax:661-864-1105
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA46570207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
D19472Medicare UPIN