Physician Compare National (NPI:1013228980)

HEALTHCARE PROVIDER: PRABHU SUDANTIRARAJ RAM M.D

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1013228980
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608016407
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130820000600
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RAM
	Individual professional last name
Provider First Name	PRABHU
	Individual professional first name
Provider Middle Name	SUDANTIRARAJ
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2004
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1200 BOSTON PROVIDENCE TPKE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	NORWOOD
	Group Practice or individual's city
State	MA
	Group Practice or individual's state
Zip Code	020625086
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	220126
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORWOOD HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	220080
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOLY FAMILY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	220008
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	STURDY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y