Healthcare Provider Details

I. General information

NPI: 1699704577
Provider Name (Legal Business Name): VISHNU EARLE RAMPERSAUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4649 NANNIE HELEN BURROUGHS AVE NE
WASHINGTON DC
20019-3662
US

IV. Provider business mailing address

3144 HEWITT AVE APT 143
SILVER SPRING MD
20906-4959
US

V. Phone/Fax

Practice location:
  • Phone: 202-398-4700
  • Fax: 202-398-4701
Mailing address:
  • Phone: 301-437-8339
  • Fax: 301-871-1273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberDC9106
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: