=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730165986
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAMESH BILLY LAKHRAM M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2005
-----------------------------------------------------
Last Update Date | 09/26/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4007 ESTATE DIAMOND RUBY
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00820-4435
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 340-778-6311
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5650
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00823-5650
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 340-626-6667
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number | 1345
-----------------------------------------------------
License Number State | VI
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | ME74211
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------