Provider Demographics
NPI:1740493501
Name:JAYARAMAN, LATHA M (MD)
Entity type:Individual
Prefix:DR
First Name:LATHA
Middle Name:M
Last Name:JAYARAMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:822 KUMHO DR
Mailing Address - Street 2:SUITE NUMBER 202
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-9297
Mailing Address - Country:US
Mailing Address - Phone:330-576-0500
Mailing Address - Fax:330-576-0467
Practice Address - Street 1:822 KUMHO DR
Practice Address - Street 2:SUITE NUMBER 202
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-9297
Practice Address - Country:US
Practice Address - Phone:330-576-0500
Practice Address - Fax:330-576-0467
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2011-03-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35.092072208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist