Healthcare Provider Details

I. General information

NPI: 1972819092
Provider Name (Legal Business Name): RAMESH BABU RAMACHANDRAN MBBS, MRCP, FRCR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2010
Last Update Date: 08/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 BROOKLINE AVE NEURORADIOLOGY, BIDMC
BOSTON MA
02215-5400
US

IV. Provider business mailing address

330 BROOKLINE AVE NEURORADIOLOGY, BIDMC
BOSTON MA
02215-5400
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-2038
  • Fax:
Mailing address:
  • Phone: 617-754-2038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License Number243344
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: