Provider Demographics
NPI:1215506597
Name:VEJJU, RAMA SUNITHA (PHARMD)
Entity type:Individual
Prefix:
First Name:RAMA
Middle Name:SUNITHA
Last Name:VEJJU
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W241N5635 MAPLE GROVE LN
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3915
Mailing Address - Country:US
Mailing Address - Phone:414-704-6989
Mailing Address - Fax:
Practice Address - Street 1:1021 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:OCONOMOWOC
Practice Address - State:WI
Practice Address - Zip Code:53066-4499
Practice Address - Country:US
Practice Address - Phone:262-567-9173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20140-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist