Dr. Subhaschandra Reddy Ravi
General Practice Physician
30 W Main St
Hartford
, Michigan 49057-1005
Dr. Subhaschandra Reddy Ravi
General Practice Physician
30 W Main St
Hartford
, Michigan 49057-1005
(269) 621-2566
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About
Features
Specialties
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Subhaschandra Reddy Ravi
- 30 W Main St
- Hartford, MI
- Zip : 49057-1005
- Fax : (269) 621-2566
- Phone : (269) 621-2166
Second Address
- Dr. Subhaschandra Reddy Ravi
- 30 W Main St
- Hartford, MI
- Zip : 49057-1005
- Fax : (269) 621-2566
- Phone : (269) 621-2166
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208D00000X | General Practice Physician | 4301037460 | MI |
National Provider Identifier
| NPI | 1043379803 |
|---|---|
| Provider Name | Dr. Subhaschandra Reddy Ravi |
| First Address | Hartford, MI 49057-1005 |
| Second Address | Hartford, MI 49057-1005 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/12/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 11286631 | CAQH (01) | MI |
| 1790118 | (05) | MI |
| 3508062072 | BCBS OF MICHIGAN (01) | MI |
| B45885 | (02) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.