Provider Demographics
NPI:1881630895
Name:VEDULA, RAMESH (MD)
Entity type:Individual
Prefix:
First Name:RAMESH
Middle Name:
Last Name:VEDULA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1001 BELLEFONTAINE AVE
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45804-2800
Mailing Address - Country:US
Mailing Address - Phone:419-998-4575
Mailing Address - Fax:419-998-4586
Practice Address - Street 1:5151 E HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:SIERRA VISTA
Practice Address - State:AZ
Practice Address - Zip Code:85635-2436
Practice Address - Country:US
Practice Address - Phone:520-803-6644
Practice Address - Fax:520-459-3193
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIRV0756892085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA4201651Medicaid
FL9994243OtherCIGNA
FL1115827OtherCARE PLUS
MI320Z910000OtherBLUE CROSS
FL007964000Medicaid
FL361073OtherAVMED
FL1122369OtherWELLCARE
FLP01451892OtherRR MEDICARE
FL7699059OtherAETNA
FL9994243OtherCIGNA
FL7699059OtherAETNA
FL1115827OtherCARE PLUS
FLGT895PMedicare PIN