Basic Information
Provider Information
NPI: 1841251576
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANGARAJAN
FirstName: RAMASWAMY
MiddleName: I
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5401 OLD COURT RD
Address2: ATTN: CREDENTIALING
City: RANDALLSTOWN
State: MD
PostalCode: 211335103
CountryCode: US
TelephoneNumber: 4106015524
FaxNumber: 4106018946
Practice Location
Address1: 5401 OLD COURT RD
Address2:  
City: RANDALLSTOWN
State: MD
PostalCode: 211335103
CountryCode: US
TelephoneNumber: 4105212200
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/31/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XD54288MDY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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