Medavaram, Rama

Medavaram, Rama is an individual health care provider with primary practice located at 1851 Sibley Blvd , Calumet City IL 60409-2252. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Medavaram, Rama can be contacted via phone (708) 868-2300.

Contact Information

Primary practice address
1851 Sibley Blvd Calumet City IL 60409-2252
Fax: (708) 868-2304
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036065913 Illinois

Profile Details

NPI number 1780780114
LBN Legal business name Medavaram, Rama
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Jan 25th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780780114 NPPES
Illinois MEDICAID 036065913
Illinois Other 7663829
Illinois Other 31602204

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