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NPI Code Detail

MEDICARE: CHIDAMBARAM RAMASAMY MD

MEDICARE: CHIDAMBARAM RAMASAMY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramCT
2390200000XStudent in an Organized Health Care Education/Training Program280025MA
3207RH0003XHematology & Oncology PhysicianE-19946AR

General Provider Information

NPI Number : 1275187684
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHIDAMBARAM RAMASAMY MD
Provider Business Mailing Address
First Line : 7001 ROGERS AVE STE 200
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4022
Country : US
Telephone Number : 479-314-7490
Fax Number : 479-314-7494
Provider Business Practice Location Address
First Line : 7001 ROGERS AVE STE 200
Second Line :
City : FORT SMITH
State : AR
Zip : 72903-4022
Country : US
Telephone Number : 479-314-7490
Fax Number : 479-314-7494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2019
Last Update Date : 06/04/2026

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