Organization
SURAPANENI RAMANADHARAO MDPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURAPANENI P RAMANADHARAO M.D. (PHYSICIAN/OWNER)
(207) 942-3878
Entity
Organization
Contact information
Practice address
358 BROADWAY, SUITE 207, BANGOR, ME 04401-3929
(207) 942-3878
(207) 990-2803
Mailing address
PO BOX 8117, BANGOR, ME 04402-8117
(207) 942-3878
(207) 990-2803
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
9356
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112410000
—
ME
Enumeration date
10/05/2011
Last updated
10/05/2011
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