Provider Demographics
NPI:1669424297
Name:RAMAN, BHARAT B (MD)
Entity type:Individual
Prefix:
First Name:BHARAT
Middle Name:B
Last Name:RAMAN
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 1:1185 CORPORATE CENTER DR STE 175
Mailing Address - Street 2:
Mailing Address - City:OCONOMOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:53066-4889
Mailing Address - Country:US
Mailing Address - Phone:262-928-8400
Mailing Address - Fax:262-928-8484
Practice Address - Street 1:1185 CORPORATE CENTER DR STE 175
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4889
Practice Address - Country:US
Practice Address - Phone:262-928-8400
Practice Address - Fax:262-928-8484
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43487-020207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34130900Medicaid
WI9353OtherDEAN HEALTH INSURANCE
WI9353OtherDEAN HEALTH INSURANCE
WI34130900Medicaid
F84100Medicare UPIN
WI110228531Medicare PIN