Individual
JONATHAN RAMESH VAMADEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6787
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MB12720800
NJ
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
25MB12720800
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2022
Last updated
04/10/2026
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