Provider Demographics
NPI:1164653945
Name:GANGI, RATNA PRIYA (MD)
Entity type:Individual
Prefix:DR
First Name:RATNA PRIYA
Middle Name:
Last Name:GANGI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 PLEASANT ST
Mailing Address - Street 2:STE 414
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1416
Mailing Address - Country:US
Mailing Address - Phone:515-241-5700
Mailing Address - Fax:515-241-5775
Practice Address - Street 1:1215 PLEASANT ST
Practice Address - Street 2:STE 414
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1416
Practice Address - Country:US
Practice Address - Phone:515-241-5700
Practice Address - Fax:515-241-5775
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2016-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NETEP-6166207R00000X
IAMD-40588207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1164653945Medicaid