Provider Demographics
NPI:1982912689
Name:PERIYASAMY, RAMESHKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMESHKUMAR
Middle Name:
Last Name:PERIYASAMY
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 1:2512 S 7TH ST
Mailing Address - Street 2:R 200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1404
Mailing Address - Country:US
Mailing Address - Phone:612-273-1177
Mailing Address - Fax:612-273-7959
Practice Address - Street 1:2512 S 7TH ST
Practice Address - Street 2:R 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1404
Practice Address - Country:US
Practice Address - Phone:612-273-1177
Practice Address - Fax:612-273-7959
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program