Basic Information
| Provider Information | |||||||||
| NPI: | 1952563454 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAKHTIANI | ||||||||
| FirstName: | RAMCHANDUR | ||||||||
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| Credential: | MBBS, MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 856 J CLYDE MORRIS BLVD STE A | ||||||||
| Address2: | RIVERSIDE MEDICAL GROUP | ||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236011318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7575944006 | ||||||||
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| Practice Location | |||||||||
| Address1: | 739 THIMBLE SHOALS BLVD | ||||||||
| Address2: | SUITE 801 | ||||||||
| City: | NEWPORT NEWS | ||||||||
| State: | VA | ||||||||
| PostalCode: | 236063562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7578731009 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/26/2008 | ||||||||
| LastUpdateDate: | 07/13/2016 | ||||||||
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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 | 207RN0300X | 0101260524 | VA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.