MEDICARE: HIMABINDU RAVI

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	2084B0040X	Behavioral Neurology & Neuropsychiatry Physician	2003-00281	NC
2	2084P0800X	Psychiatry Physician	C160213	CA
3	2084P0804X	Child & Adolescent Psychiatry Physician	20030081	NC
4	2084P0800X	Psychiatry Physician	2003-00281	NC

General Provider Information

NPI Number	:	1629152541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIMABINDU RAVI

Provider Business Mailing Address
First Line	:	301 PINNER WEALD WAY
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-2618
Country	:	US
Telephone Number	:	919-346-3363
Fax Number	:

Provider Business Practice Location Address
First Line	:	301 PINNER WEALD WAY # PA
Second Line	:
City	:	CARY
State	:	NC
Zip	:	27513-2618
Country	:	US
Telephone Number	:	919-346-3363
Fax Number	:

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

Provider Enumeration Date	:	10/25/2006
Last Update Date	:	05/24/2022

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