Provider Demographics
NPI:1679534846
Name:RAMASWAMY, MAMATHA (MD)
Entity type:Individual
Prefix:DR
First Name:MAMATHA
Middle Name:
Last Name:RAMASWAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1515 SW CARY PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-6224
Mailing Address - Country:US
Mailing Address - Phone:919-387-3176
Mailing Address - Fax:919-387-3244
Practice Address - Street 1:1515 SW CARY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-6224
Practice Address - Country:US
Practice Address - Phone:919-387-3176
Practice Address - Fax:919-387-3244
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001259207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891359FMedicaid
2282868AMedicare PIN
NC891359FMedicaid