Provider Demographics
NPI:1962558171
Name:DONEPUDI, RAMESH (MD, MRCP)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:
Last Name:DONEPUDI
Suffix:
Gender:M
Credentials:MD, MRCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19711 WELLINGTON MANOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-5011
Mailing Address - Country:US
Mailing Address - Phone:774-267-1226
Mailing Address - Fax:
Practice Address - Street 1:1324 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-4543
Practice Address - Country:US
Practice Address - Phone:863-687-1321
Practice Address - Fax:863-284-1730
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231792207R00000X, 207RC0200X, 207RS0012X, 208M00000X, 208M00000X, 207RS0012X
SC31114207RC0200X
FLME145720207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110080140AMedicaid
NHP01292877OtherRAILROAD MEDICARE
NH3095041Medicaid
MA2158141Medicaid
NHP01292877OtherRAILROAD MEDICARE
NH3095041Medicaid
SC8469Medicare PIN