Individual
RANJIT S RISAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3060 MITCHELLVILLE RD, 210, BOWIE, MD 20716-1389
(301) 249-4090
Mailing address
3060 MITCHELLVILLE RD, 210, BOWIE, MD 20716-1389
(301) 249-4090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0032769
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100010
UNITEDHEALTHCARE ID
—
01
—
203250
HEALTHKEEPERS
VA
01
—
41986001
CAREFIRST MD
MD
01
—
42350001
CAREFIRST DC
DC
01
—
497053
NCPPO ID
—
01
—
5056288
AETNA ID
—
01
—
819810
MAMSI PRODUCTS ID
—
Enumeration date
09/08/2005
Last updated
07/09/2007
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