Healthcare Provider Details

I. General information

NPI: 1669424297
Provider Name (Legal Business Name): BHARAT B RAMAN MBBS, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 06/13/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 ELM STREET N
FARGO ND
58102
US

IV. Provider business mailing address

2101 ELM STREET N
FARGO ND
58102
US

V. Phone/Fax

Practice location:
  • Phone: 701-239-3700
  • Fax: 262-928-8484
Mailing address:
  • Phone: 701-239-3700
  • Fax: 262-928-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number43487-020
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: