Basic Information
Provider Information
NPI: 1174906374
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BANIYA
FirstName: RAMKAJI
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
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Mailing Information
Address1: 5959 S SHERWOOD FOREST BLVD
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708166038
CountryCode: US
TelephoneNumber: 2255260269
FaxNumber: 2257659196
Practice Location
Address1: 7777 HENNESSY BLVD STE 701
Address2:  
City: BATON ROUGE
State: LA
PostalCode: 708084370
CountryCode: US
TelephoneNumber: 2257655864
FaxNumber: 2257652013
Other Information
ProviderEnumerationDate: 07/07/2015
LastUpdateDate: 01/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X4301107726MIN Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X310564LAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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