Provider Demographics
NPI:1104915602
Name:CHAUDHURI, RAMESWAR (MD)
Entity type:Individual
Prefix:
First Name:RAMESWAR
Middle Name:
Last Name:CHAUDHURI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 E APPLE ST
Mailing Address - Street 2:STE NW 3300
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2939
Mailing Address - Country:US
Mailing Address - Phone:937-208-8394
Mailing Address - Fax:937-208-8388
Practice Address - Street 1:30 E APPLE ST
Practice Address - Street 2:SUITE NW 3300
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2939
Practice Address - Country:US
Practice Address - Phone:937-208-8394
Practice Address - Fax:937-208-8388
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35075882207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000508356OtherBCBS CLARK COUNTY
OH000000507730OtherBCBS
000000508835OtherBCBS FAIRFIELD HOS
OH2757271Medicaid
P00446392OtherFAIRFIELD HOS RR
OH2323613Medicaid
P00449147OtherRR MEDICARE
OH4204953Medicare PIN
CH4204952Medicare PIN
000000508356OtherBCBS CLARK COUNTY
OH2757271Medicaid
OH4204956Medicare PIN
OH2323613Medicaid