Healthcare Provider Details

I. General information

NPI: 1417637174
Provider Name (Legal Business Name): RUPESH RAMTEL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 S WASHINGTON ST
EASTON MD
21601-2913
US

IV. Provider business mailing address

11 N MAIN ST
NATICK MA
01760-3488
US

V. Phone/Fax

Practice location:
  • Phone: 410-822-1000
  • Fax:
Mailing address:
  • Phone: 419-215-8904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0106151
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: