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General NPI Number Information
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NPI Number | 1891127882
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Entity Type | Individual
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Provider Name | RAMATU DOMAY RAJU NP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2013
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 7955 TUCKERMAN LANE
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City | ROCKVILLE
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State | MD
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Zip | 20854
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Country | US
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Telephone | 866-389-2727
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Fax | 401-652-9787
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Provider Business Mailing Address
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Address Line | 8510 16TH ST APT. # 216
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City | SILVER SPRING
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State | MD
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Zip | 20910-2970
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Country | US
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Telephone | 301-758-4984
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R180570
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License Number State | MD
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