Basic Information
| Provider Information | |||||||||
| NPI: | 1871563858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAMADUGU | ||||||||
| FirstName: | PARAMESH | ||||||||
| MiddleName: | B | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 115 8TH ST NE | ||||||||
| Address2: | |||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 52401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193633565 | ||||||||
| FaxNumber: | 3193634001 | ||||||||
| Practice Location | |||||||||
| Address1: | 115 8TH ST NE | ||||||||
| Address2: | |||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 52401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193633565 | ||||||||
| FaxNumber: | 3193634001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2006 | ||||||||
| LastUpdateDate: | 09/11/2013 | ||||||||
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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 | 207R00000X | 11641 | NV | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 39123 | IA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 39123 | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
ID Information
| ID | Type | State | Issuer | Description | 100506829 | 05 | NV | MEDICAID |