Provider Demographics
NPI:1619416757
Name:RAMINENI MD LLC
Entity type:Organization
Organization Name:RAMINENI MD LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRAFUL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMINENI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-288-0285
Mailing Address - Street 1:6537 SOTHORON RD
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3022
Mailing Address - Country:US
Mailing Address - Phone:202-288-0285
Mailing Address - Fax:202-785-4187
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-288-0285
Practice Address - Fax:202-785-1370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD036474208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty