Provider Demographics
NPI:1215917166
Name:RAM, SANT (MD)
Entity type:Individual
Prefix:
First Name:SANT
Middle Name:
Last Name:RAM
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 1:1 LECOM PL
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-2571
Mailing Address - Country:US
Mailing Address - Phone:814-868-2529
Mailing Address - Fax:814-868-2522
Practice Address - Street 1:537 W 18TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-1722
Practice Address - Country:US
Practice Address - Phone:814-453-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD038978L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000034005OtherKEYSTONE
PA526224OtherAETNA HEALTHCARE
PAG23929OtherWELLPATH SELECT INC
PA219229OtherUPMC HEALTH PLAN
PA0008107530001Medicaid
PA4332685OtherCIGNA HEALTHCARE
PAG23929OtherHEALTH AMERICA/HEALTH ASS
PA00050140001OtherUNIVERA HEALTH