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NPI Code Detail

MEDICARE: RAVITEJA SURYADEVARA MD

MEDICARE: RAVITEJA SURYADEVARA 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
12085R0202XDiagnostic Radiology PhysicianR6185KY

General Provider Information

NPI Number : 1487282034
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAVITEJA SURYADEVARA MD
Provider Business Mailing Address
First Line : 101 MANNING DR
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27514-4220
Country : US
Telephone Number : 984-974-1884
Fax Number :
Provider Business Practice Location Address
First Line : 101 MANNING DR
Second Line :
City : CHAPEL HILL
State : NC
Zip : 27514-4220
Country : US
Telephone Number : 502-852-5875
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2020
Last Update Date : 06/12/2026

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Directions to “ RAVITEJA SURYADEVARA MD” Practice Location

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