Provider Demographics
NPI:1194716282
Name:PAIDI, RAMACHANDRA R (MD)
Entity type:Individual
Prefix:DR
First Name:RAMACHANDRA
Middle Name:R
Last Name:PAIDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30475-0269
Mailing Address - Country:US
Mailing Address - Phone:912-537-6060
Mailing Address - Fax:912-537-6020
Practice Address - Street 1:106 QUEEN ST
Practice Address - Street 2:SUITE 1A
Practice Address - City:VIDALIA
Practice Address - State:GA
Practice Address - Zip Code:30474-4210
Practice Address - Country:US
Practice Address - Phone:912-537-6060
Practice Address - Fax:912-537-6020
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0499312084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00980427AMedicaid
GA00980427AMedicaid
GA86BBBBKMedicare ID - Type Unspecified