MEDICARE: RAVINDRA P MALAPUR MBBS,DGO,MD,ARDMS

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
1	2471S1302X	Sonography Radiologic Technologist	2471S1302X	WV

General Provider Information

NPI Number	:	1588805253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAVINDRA P MALAPUR MBBS,DGO,MD,ARDMS

Provider Business Mailing Address
First Line	:	250 EUREKA RD
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25314-2126
Country	:	US
Telephone Number	:	304-342-0556
Fax Number	:	304-342-0556

Provider Business Practice Location Address
First Line	:	250 EUREKA RD
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25314-2126
Country	:	US
Telephone Number	:	304-342-0556
Fax Number	:	304-342-0556

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2009
Last Update Date	:	03/10/2009

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