Basic Information
| Provider Information | |||||||||
| NPI: | 1225015811 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMSARAN | ||||||||
| FirstName: | EDDISON | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016081216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683130 | ||||||||
| FaxNumber: | 5083683133 | ||||||||
| Practice Location | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
| Address2: | SUITE 290 N | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083683130 | ||||||||
| FaxNumber: | 5083683133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2005 | ||||||||
| LastUpdateDate: | 06/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0011X | 75426 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
ID Information
| ID | Type | State | Issuer | Description | 0103551 | 01 | HEALTHY START | OTHER | 042472266 | 01 | THREE RIVERS | OTHER | 784072 | 01 | MVP HEALTH CARE | OTHER | J22626 | 01 | BLUE CARE ELECT | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | AA4383 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | J22626 | 01 | BLUE SHIELD INDEMNITY | OTHER | 0103551 | 05 | MA | MEDICAID | 04247226 | 01 | ONE HEALTH PLAN | OTHER | 2500807 | 01 | EVERCARE | OTHER | 042472266 | 01 | TRICARE CHAMPUS | OTHER | 060060854 | 01 | RAILRAOD MEDICARE | OTHER | 457619 | 01 | TUFTS HEALTH PLAN | OTHER | 45823 | 01 | FALLON COMMUNITY HEALTH P | OTHER | J22626 | 01 | BLUE SHIELD HMO BLUE | OTHER | 0171277 | 01 | CIGNA HEALTH PLAN | OTHER | 042472266 | 01 | HEALTHCARE VAULE MANAGEME | OTHER | 5048284 | 01 | AETNA US HEALTHCARE | OTHER |