MEDICARE: JAMES ALAN RAMENOFSKY 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
1	207RN0300X	Nephrology Physician	G36057	CA
2	207RN0300X	Nephrology Physician	45774	AZ
3	207RN0300X	Nephrology Physician	0101254709	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0101254709	OTHER	VA	MEDICAL LICENSE
2	G36057	OTHER	CA	LICENSE NUMBER
3	45774	OTHER	AZ	AZ MEDICAL LICENSE

General Provider Information

NPI Number	:	1093713422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ALAN RAMENOFSKY M.D.

Provider Business Mailing Address
First Line	:	1625 N GEORGE MASON DR
Second Line	:	SUITE 425
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3683
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 N GEORGE MASON DR
Second Line	:	SUITE 425
City	:	ARLINGTON
State	:	VA
Zip	:	22205-3683
Country	:	US
Telephone Number	:	703-717-4400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	04/01/2014

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