Healthcare Provider Details

I. General information

NPI: 1205901899
Provider Name (Legal Business Name): NALINI RAMAIYA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/31/2023
Certification Date: 07/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 INGLESIDE AVE
MACON GA
31204-2036
US

IV. Provider business mailing address

235 PEACHTREE ST NE NORTH TOWER, SUITE 2100
ATLANTA GA
30303-1401
US

V. Phone/Fax

Practice location:
  • Phone: 478-845-7462
  • Fax: 855-791-3372
Mailing address:
  • Phone: 770-994-4747
  • Fax: 770-994-9326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number27241
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number27241
License Number StateGA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: