Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35041646R | OH |
NPI | 1033399522 |
---|---|
Provider Name | Dr. Raveendra Babu Ravi |
First Address | Ashtabula, OH 44004-4953 |
Second Address | Ashtabula, OH 44004-4953 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2007 |
Last Update Date | 22/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0431143 | (05) | OH |
340003631 | RR MEDICARE (01) | |
A77528 | (02) |