MEDICARE: DR. KRISH RAMACHANDRAN 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	174400000X	Specialist	0101052788	VA
2	207RC0000X	Cardiovascular Disease Physician	0101052788	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396749255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISH RAMACHANDRAN M.D.

Provider Business Mailing Address
First Line	:	2001 CRYSTAL SPRING AVE SW
Second Line	:	STE 300
City	:	ROANOKE
State	:	VA
Zip	:	24014-2465
Country	:	US
Telephone Number	:	540-342-7941
Fax Number	:	540-345-8423

Provider Business Practice Location Address
First Line	:	2001 CRYSTAL SPRING AVE SW
Second Line	:	STE 300
City	:	ROANOKE
State	:	VA
Zip	:	24014-2465
Country	:	US
Telephone Number	:	540-342-7941
Fax Number	:	540-345-8423

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/15/2015

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