Healthcare Provider Details

I. General information

NPI: 1487447819
Provider Name (Legal Business Name): RAMYA GNANARAJ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 18TH ST S STE 200
BIRMINGHAM AL
35233-1856
US

IV. Provider business mailing address

1720 UNIVERSITY BLVD STE 305
BIRMINGHAM AL
35233-1816
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8620
  • Fax: 205-325-8654
Mailing address:
  • Phone: 205-325-8620
  • Fax: 205-325-8654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberL.6844
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207WX0109X
TaxonomyNeuro-ophthalmology Physician
License NumberLT001067
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: