Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OT015430 | PA |
NPI | 1003254715 |
---|---|
Provider Name | Dr. Anu Ramdas |
First Address | Wynnewood, PA 19096-1604 |
Second Address | Broomall, PA 19008-3512 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2013 |
Last Update Date | 05/06/2013 |