Basic Information
| Provider Information | |||||||||
| NPI: | 1508197997 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GUTHIKONDA | ||||||||
| FirstName: | RAMESH | ||||||||
| MiddleName: | BABU | ||||||||
| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79 AMELIA AVE | ||||||||
| Address2: | |||||||||
| City: | LIVINGSTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070392942 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9735191260 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3333 W DEYOUNG ST | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | IL | ||||||||
| PostalCode: | 629595884 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6189987000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2010 | ||||||||
| LastUpdateDate: | 05/05/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036126562 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.