Healthcare Provider Details

I. General information

NPI: 1720224223
Provider Name (Legal Business Name): ARUN RANGANATH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2009
Last Update Date: 09/27/2024
Certification Date: 09/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 HOSPITAL RD
TAPPAHANNOCK VA
22560-5000
US

IV. Provider business mailing address

6 E CHESTNUT ST
AUGUSTA ME
04330-5717
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-4635
  • Fax: 804-443-6150
Mailing address:
  • Phone: 207-626-1236
  • Fax: 207-626-1549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number018223
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number0101282597
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number2507
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number018223
License Number StateME
# 5
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number227982
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: