Basic Information
| Provider Information | |||||||||
| NPI: | 1346464849 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMA | ||||||||
| FirstName: | SREEDHAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5820 GOLDEN BEAR DR | ||||||||
| Address2: | |||||||||
| City: | OVERLAND PARK | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662232950 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144625095 | ||||||||
| FaxNumber: | 4844939908 | ||||||||
| Practice Location | |||||||||
| Address1: | 2316 E MEYER BLVD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 64132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162767650 | ||||||||
| FaxNumber: | 8162767090 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 02/04/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | 2017040910 | MO | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | MD430486 | PA | N | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | 2017040910 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1018828490001 | 05 | PA | MEDICAID | MD430486 | 01 | PA | STATE LICENSE | OTHER |