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NPI Code Detail

MEDICARE: GANESH RAM PA

MEDICARE: GANESH RAM PA
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
1363AM0700XMedical Physician Assistant950WI
2363AS0400XSurgical Physician Assistant950WI
3363AS0400XSurgical Physician Assistant2005034534MO
4363A00000XPhysician Assistant950WI

General Provider Information

NPI Number : 1467456848
Entity Type Code : Individual
Provider Name (Legal Business Name) : GANESH RAM PA
Provider Business Mailing Address
First Line : 200 1ST ST SW
Second Line :
City : ROCHESTER
State : MN
Zip : 55905-0001
Country : US
Telephone Number : 507-284-2511
Fax Number :
Provider Business Practice Location Address
First Line : 1400 BELLINGER ST
Second Line :
City : EAU CLAIRE
State : WI
Zip : 54703-5222
Country : US
Telephone Number : 715-838-5222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 07/24/2024

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Directions to “ GANESH RAM PA” Practice Location

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