Provider Demographics
NPI:1104073808
Name:KUNASANI, RATNA M (MD)
Entity type:Individual
Prefix:
First Name:RATNA
Middle Name:M
Last Name:KUNASANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7300 HANOVER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2250
Mailing Address - Country:US
Mailing Address - Phone:301-486-4690
Mailing Address - Fax:301-441-8809
Practice Address - Street 1:7300 HANOVER DR STE 104
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2250
Practice Address - Country:US
Practice Address - Phone:301-486-4690
Practice Address - Fax:301-441-8809
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2401382086S0129X, 208G00000X
WI666412086S0129X
PAMD4251612086S0129X
MA2410032086S0129X
GA0728522086S0129X
FLME1210252086S0129X
NY240138-1390200000X
MDD00716902086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100061773Medicaid
PA1025775030004Medicaid
PAPO1806060OtherRAILROAD MEDICARE
PA1025775060001Medicaid
MD117766400Medicaid