Healthcare Provider Details

I. General information

NPI: 1285934414
Provider Name (Legal Business Name): RAMAPRASAD SRINIVASAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2010
Last Update Date: 10/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 ROCKVILLE PIKE BLDG 10 CRC ROOM 2-5950
BETHESDA MD
20892-1210
US

IV. Provider business mailing address

9000 ROCKVILLE PIKE BLDG 10 CRC ROOM 2-5950
BETHESDA MD
20892-1210
US

V. Phone/Fax

Practice location:
  • Phone: 301-496-6353
  • Fax: 301-402-0922
Mailing address:
  • Phone: 301-496-6353
  • Fax: 301-402-0922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number0101229944
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: