Individual
THEKKEMADOM RAMAKRISHNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2925 WILLIAM PENN HIGHWAY, SUITE # 303, EASTON, PA 18045
(610) 559-9622
Mailing address
2925 WILLIAM PENN HWY, SUITE # 303, EASTON, PA 18045-5283
(610) 559-9622
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
MD041515L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012228270002
—
PA
01
—
01964701
CAPITAL BLUE CROSS OF PA
—
01
—
608831
HIGHMARK BLUE SHIELD
PA
Enumeration date
02/08/2006
Last updated
01/23/2011
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