Basic Information
| Provider Information | |||||||||
| NPI: | 1619015575 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMBALLY | ||||||||
| FirstName: | CHERRIDAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 944 OAK RIDGE TURNPIKE | ||||||||
| Address2: | |||||||||
| City: | OAK RIDGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 37830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8658353810 | ||||||||
| FaxNumber: | 8658353811 | ||||||||
| Practice Location | |||||||||
| Address1: | 944 OAK RIDGE TPKE | ||||||||
| Address2: | |||||||||
| City: | OAK RIDGE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378306917 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8658353810 | ||||||||
| FaxNumber: | 8658353811 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 07/20/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0012X | 0420011690 | VT | N | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | 2084N0400X | 0600003426 | VT | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 2084N0400X | 45091 | TN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 207RS0012X | 45091 | TN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.