Healthcare Provider Details

I. General information

NPI: 1942649710
Provider Name (Legal Business Name): RAMANAN ROM SATCHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MR. RAMANAN SATCHIDANANTHAN

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 02/18/2021
Certification Date: 02/12/2021
Deactivation Date: 04/03/2014
Reactivation Date: 07/31/2014

III. Provider practice location address

6850 N DURANGO DR STE 120
LAS VEGAS NV
89149-4596
US

IV. Provider business mailing address

4575 DEAN MARTIN DR UNIT 2411
LAS VEGAS NV
89103-8210
US

V. Phone/Fax

Practice location:
  • Phone: 702-944-4028
  • Fax:
Mailing address:
  • Phone: 212-641-0312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number125064085
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: