MEDICARE: MOHINDRA RAMPHAL OD

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	152W00000X	Optometrist	TA2326	MD

General Provider Information

NPI Number	:	1366794638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHINDRA RAMPHAL OD

Provider Business Mailing Address
First Line	:	2661 RIVA RD STE 1030
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7131
Country	:	US
Telephone Number	:	667-354-5528
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 CHAMPION DR STE 100
Second Line	:
City	:	HAGERSTOWN
State	:	MD
Zip	:	21740-6665
Country	:	US
Telephone Number	:	301-791-0888
Fax Number	:	301-791-3611

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

Provider Enumeration Date	:	10/10/2012
Last Update Date	:	04/03/2026

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