Healthcare Provider Details

I. General information

NPI: 1497378855
Provider Name (Legal Business Name): CHAMPION HEART AND VASCULAR CENTER, OXFORD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2020
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1614 WILLIAMSBORO ST
OXFORD NC
27565-5016
US

IV. Provider business mailing address

1614 WILLIAMSBORO STREET
OXFORD NC
27565
US

V. Phone/Fax

Practice location:
  • Phone: 919-339-4077
  • Fax: 855-618-2311
Mailing address:
  • Phone: 919-339-4077
  • Fax: 855-618-2311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RADHAKRISHNAN RAMARAJ
Title or Position: PRESIDENT
Credential: MD
Phone: 910-304-1212