Healthcare Provider Details

I. General information

NPI: 1376954693
Provider Name (Legal Business Name): RAM NARAYAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2014
Last Update Date: 09/18/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 89TH AVE
MERRILLVILLE IN
46410-7318
US

IV. Provider business mailing address

345 HARRISON AVE APT 541
BOSTON MA
02118-3068
US

V. Phone/Fax

Practice location:
  • Phone: 219-738-5598
  • Fax:
Mailing address:
  • Phone: 606-422-3974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number036148357
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number01081948A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35.150233
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: