Provider Demographics
NPI:1780615377
Name:BAKANE, RAMESH (MD)
Entity type:Individual
Prefix:
First Name:RAMESH
Middle Name:
Last Name:BAKANE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2460 LEE HWY N
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PULASKI
Mailing Address - State:VA
Mailing Address - Zip Code:24301-2335
Mailing Address - Country:US
Mailing Address - Phone:540-980-3914
Mailing Address - Fax:540-980-9595
Practice Address - Street 1:2460 LEE HWY N
Practice Address - Street 2:SUITE 5
Practice Address - City:PULASKI
Practice Address - State:VA
Practice Address - Zip Code:24301-2335
Practice Address - Country:US
Practice Address - Phone:540-980-3914
Practice Address - Fax:540-980-9595
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238658207RP1001X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1780615377Medicaid
VAP00285528OtherMEDICARE RR
VA00W887P01Medicare PIN
VAP00285528OtherMEDICARE RR
VA1780615377Medicaid