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NPI Code Detail

MEDICARE: SRIHARI RAVI MD

MEDICARE: SRIHARI RAVI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician4301058818MI
2207RI0011XInterventional Cardiology Physician4301058818MI
3207UN0901XNuclear Cardiology Physician4301058818MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2OH-26467009OTHERMIMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060-500-7971OTHERMIBLUECROSS BLUE SHIELD

General Provider Information

NPI Number : 1184626731
Entity Type Code : Individual
Provider Name (Legal Business Name) : SRIHARI RAVI MD
Provider Business Mailing Address
First Line : 25195 KELLY RD
Second Line : SUITE A
City : ROSEVILLE
State : MI
Zip : 48066-4909
Country : US
Telephone Number : 586-775-4594
Fax Number : 586-775-4506
Provider Business Practice Location Address
First Line : 25195 KELLY RD
Second Line : SUITE A
City : ROSEVILLE
State : MI
Zip : 48066-4909
Country : US
Telephone Number : 586-775-4594
Fax Number : 586-775-4506
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2005
Last Update Date : 03/07/2023

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Directions to “ SRIHARI RAVI MD” Practice Location

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