MEDICARE: DR. RAVINDER SINGH KOHLI M.D.

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	207RC0000X	Cardiovascular Disease Physician	0101047753	VA
2	207RI0011X	Interventional Cardiology Physician	0101047753	VA

General Provider Information

NPI Number	:	1659334373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAVINDER SINGH KOHLI M.D.

Provider Business Mailing Address
First Line	:	89 SHERWOOD DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1447
Country	:	US
Telephone Number	:	804-526-3010
Fax Number	:	804-526-2293

Provider Business Practice Location Address
First Line	:	89 SHERWOOD DR
Second Line	:
City	:	COLONIAL HEIGHTS
State	:	VA
Zip	:	23834-1447
Country	:	US
Telephone Number	:	804-526-3010
Fax Number	:	804-526-2293

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

Provider Enumeration Date	:	04/12/2006
Last Update Date	:	05/12/2022

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