Kanakamedala, Ravi

Kanakamedala, Ravi is an individual health care provider with primary practice located at 8840 Calumet Ave Suite 103, Munster IN 46321-2529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Kanakamedala, Ravi can be contacted via phone (219) 836-7246.

Contact Information

Primary practice address
8840 Calumet Ave Suite 103 Munster IN 46321-2529
Phone: (219) 836-7246
Fax: (219) 836-6454
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X 01035342A Indiana

Profile Details

NPI number 1932108511
LBN Legal business name Kanakamedala, Ravi
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Aug 13th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932108511 NPPES
Illinois Other 01035342A BCBS OF IL
Illinois Other 050085655 BCBS OF IL
Illinois Other 5841131 BCBS OF IL
Illinois Other 000000330862 BCBS OF IL
Illinois Other 01035342A BCBS OF IL
Illinois MEDICAID 100259430A BCBS OF IL

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