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NPI Code Detail

MEDICARE: DR. RAMAN S.P DAMINENI M.D

MEDICARE: DR. RAMAN S.P DAMINENI M.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician043915GA

General Provider Information

NPI Number : 1033176573
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAMAN S.P DAMINENI M.D
Provider Business Mailing Address
First Line : 435 FAIRFIELD DR
Second Line :
City : DUBLIN
State : GA
Zip : 31021-3895
Country : US
Telephone Number : 478-275-7456
Fax Number : 478-275-7456
Provider Business Practice Location Address
First Line : 1826 VETERANS BLVD
Second Line :
City : DUBLIN
State : GA
Zip : 31021-3620
Country : US
Telephone Number : 478-272-1210
Fax Number : 478-274-5508
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2006
Last Update Date : 01/20/2012

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