Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 58811 | AZ |
NPI | 1104145325 |
---|---|
Provider Name | Rajesh Ramanathan |
First Address | Gilbert, AZ 85234 |
Second Address | Gilbert, AZ 85234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2010 |
Last Update Date | 30/10/2019 |