Provider Demographics
NPI:1285895607
Name:RAM, SHRUTHI (MD)
Entity type:Individual
Prefix:
First Name:SHRUTHI
Middle Name:
Last Name:RAM
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:125 METRO CENTER BOULEVARD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1768
Mailing Address - Country:US
Mailing Address - Phone:401-432-2520
Mailing Address - Fax:401-453-8220
Practice Address - Street 1:125 METRO CENTER BOULEVARD
Practice Address - Street 2:SUITE 2000
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1768
Practice Address - Country:US
Practice Address - Phone:401-432-2520
Practice Address - Fax:401-453-8220
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2022-05-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA2906342085R0202X
CAA1121492085R0202X
RICMD157142085R0202X
RIMD157142085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARES000Medicare UPIN