Individual
DR. RAMESH VIDAVALUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
101 DATES DR, ITHACA, NY 14850-1342
(607) 274-4585
Mailing address
10 FAIRWINDS WAY, ITHACA, NY 14850-8521
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
D66840
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03875101
—
NY
Enumeration date
11/28/2007
Last updated
08/28/2014
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