Provider Demographics
NPI:1235493693
Name:RAM, ROHIT B (MD)
Entity type:Individual
Prefix:DR
First Name:ROHIT
Middle Name:B
Last Name:RAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROHIT
Other - Middle Name:B
Other - Last Name:RAMANATHAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 30180
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84130-0180
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5295 S COMMERCE DR STE 550
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107-4736
Practice Address - Country:US
Practice Address - Phone:801-313-4110
Practice Address - Fax:801-313-4128
Is Sole Proprietor?:No
Enumeration Date:2012-07-01
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100424442085R0202X
UT12734225-12052085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology