Provider Demographics
NPI:1013994797
Name:RAMASWAMY, MURALI (MD FAAFP)
Entity Type:Individual
Prefix:
First Name:MURALI
Middle Name:
Last Name:RAMASWAMY
Suffix:
Gender:M
Credentials:MD FAAFP
Other - Prefix:
Other - First Name:R
Other - Middle Name:
Other - Last Name:MURALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1200 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27401-1004
Mailing Address - Country:US
Mailing Address - Phone:336-832-7000
Mailing Address - Fax:336-547-1828
Practice Address - Street 1:520 N ELAM AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1127
Practice Address - Country:US
Practice Address - Phone:336-547-1801
Practice Address - Fax:336-547-1828
Is Sole Proprietor?:No
Enumeration Date:2005-12-23
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC52468207R00000X, 207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0244764Medicaid
IA36797OtherWELLMARK BCBS
IA0244764Medicaid
H46634Medicare UPIN