Provider Demographics
NPI:1144266826
Name:MARAMRAJ, KISHAN RAO (MD)
Entity type:Individual
Prefix:DR
First Name:KISHAN
Middle Name:RAO
Last Name:MARAMRAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KISHAN
Other - Middle Name:RAO
Other - Last Name:MARAMRAJ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:611 MOCKSVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-2705
Mailing Address - Country:US
Mailing Address - Phone:704-633-7220
Mailing Address - Fax:
Practice Address - Street 1:611 MOCKSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-2705
Practice Address - Country:US
Practice Address - Phone:704-633-7220
Practice Address - Fax:704-647-0515
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200400143207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89137R6Medicaid
NC1144266826Medicaid
NC1144266826Medicaid
NCNCH957CMedicare PIN
NCNCH957BMedicare PIN
NCH15264Medicare UPIN
NCNCH957DMedicare PIN
NCNCH957EMedicare PIN
NC89137R6Medicaid
NC2027786Medicare PIN