Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2003-01248 | NC |
Y | 2080P0208X | Pediatric Infectious Diseases | 2003-01248 | NC |
NPI | 1326197336 |
---|---|
Provider Name | Ravi Jhaveri |
First Address | Durham, NC 27710-0001 |
Second Address | Durham, NC 27710-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
89135C1 | (05) | NC |
H95318 | (02) |