Healthcare Provider Details

I. General information

NPI: 1962088922
Provider Name (Legal Business Name): AMBIKA MAKUM RAMESH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2021
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LYTTON AVENUE
PITTSBURGH PA
15213
US

IV. Provider business mailing address

3600 FORBES AVENUE FORBES TOWER PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4850
  • Fax: 304-598-4871
Mailing address:
  • Phone: 304-598-4850
  • Fax: 304-598-4871

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number14277857-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: