Provider Demographics
NPI:1699880336
Name:RAMA K MUDDARAJ MD PC
Entity type:Organization
Organization Name:RAMA K MUDDARAJ MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MUDDARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-512-4260
Mailing Address - Street 1:13555 W MCDOWELL
Mailing Address - Street 2:201A
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338
Mailing Address - Country:US
Mailing Address - Phone:623-512-4260
Mailing Address - Fax:623-512-4264
Practice Address - Street 1:13555 W MCDOWELL
Practice Address - Street 2:201A
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338
Practice Address - Country:US
Practice Address - Phone:623-512-4260
Practice Address - Fax:623-512-4264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty