Basic Information
Provider Information
NPI: 1912956418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TAMASKAR
FirstName: RANJIT
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6559 WILSON MILLS RD STE 106A
Address2:  
City: MAYFIELD VILLAGE
State: OH
PostalCode: 441433433
CountryCode: US
TelephoneNumber: 4404491540
FaxNumber: 4404602833
Practice Location
Address1: 36100 EUCLID AVE
Address2: SUITE 270
City: WILLOUGHBY
State: OH
PostalCode: 440944456
CountryCode: US
TelephoneNumber: 4404491540
FaxNumber: 4404602833
Other Information
ProviderEnumerationDate: 05/10/2006
LastUpdateDate: 11/30/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35077865OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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