Basic Information
Provider Information
NPI: 1902850407
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAMA
FirstName: CHRISTINA
MiddleName: PHYLLIS
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 13605
Address2:  
City: GREENSBORO
State: NC
PostalCode: 274153605
CountryCode: US
TelephoneNumber: 3365471877
FaxNumber:  
Practice Location
Address1: 1200 N ELM ST
Address2:  
City: GREENSBORO
State: NC
PostalCode: 274011004
CountryCode: US
TelephoneNumber: 3368328062
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/19/2006
LastUpdateDate: 07/09/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X NCY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
80667701NCPARTNERS MEDICARE CHOICEOTHER
E413701NCMEDCOSTOTHER
715370801NCAETNAOTHER
140YC01NCBCBS NCOTHER
590131605NC MEDICAID


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