Healthcare Provider Details

I. General information

NPI: 1477874824
Provider Name (Legal Business Name): SHYAMKRISHNAN RAMDAS M.B.B.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2010
Last Update Date: 06/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4755 OGLETOWN STANTON RD SUITE 2A00
NEWARK DE
19718-0001
US

IV. Provider business mailing address

4755 OGLETOWN STANTON RD SUITE 2A00
NEWARK DE
19718-0001
US

V. Phone/Fax

Practice location:
  • Phone: 302-733-1042
  • Fax: 302-733-1068
Mailing address:
  • Phone: 302-733-1042
  • Fax: 302-733-1068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: