Ravoori, Sudha R

Ravoori, Sudha R is an individual health care provider with primary practice located at 110 Edgewater Trl , Canton GA 30115-1811. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Ravoori, Sudha R can be contacted via phone (770) 479-1417.

Contact Information

Primary practice address
110 Edgewater Trl Canton GA 30115-1811
Fax: (208) 275-1349
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 00025176 Alabama

Profile Details

NPI number 1700824224
LBN Legal business name Ravoori, Sudha R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2006
Last updated Nov 1st, 2007 - 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 1700824224 NPPES
Alaska Other 51002923 BLUE CROSS HOSPITAL BASED
Alaska Other 51532371 BLUE CROSS HOSPITAL BASED

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