Provider Demographics
NPI:1881698231
Name:RAM, CHITHRA P (MD)
Entity type:Individual
Prefix:
First Name:CHITHRA
Middle Name:P
Last Name:RAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 S 1ST ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-5404
Mailing Address - Country:US
Mailing Address - Phone:502-583-2731
Mailing Address - Fax:502-583-2733
Practice Address - Street 1:222 S 1ST ST
Practice Address - Street 2:SUITE 501
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-5404
Practice Address - Country:US
Practice Address - Phone:502-583-2731
Practice Address - Fax:502-583-2733
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY370432085R0202X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000340962OtherANTHEM
KY64079965Medicaid
KYP00192321OtherRAILROAD MEDICARE
IN200477990Medicaid
KYP00619371OtherRAILROAD MEDICARE
KYI04106Medicare UPIN
KY0276168Medicare ID - Type Unspecified
KYP00192321OtherRAILROAD MEDICARE
IN200477990Medicaid