Healthcare Provider Details

I. General information

NPI: 1912304585
Provider Name (Legal Business Name): RAVI KUMAR METAI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8954 HOSPITAL DR
DOUGLASVILLE GA
30134-2272
US

IV. Provider business mailing address

8954 HOSPITAL DR
DOUGLASVILLE GA
30134-2272
US

V. Phone/Fax

Practice location:
  • Phone: 678-838-2585
  • Fax: 678-838-2587
Mailing address:
  • Phone: 678-838-2585
  • Fax: 678-838-2587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2017-01781
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number83745
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2017-01781
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: