Healthcare Provider Details

I. General information

NPI: 1013854702
Provider Name (Legal Business Name): RUTVIK SATISHKUMAR RAVAL M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6071 W OUTER DR., SINAI-GRACE HOSPITAL
DETROIT MI
48235
US

IV. Provider business mailing address

6071 W OUTER DR., SINAI-GRACE HOSPITAL
DETROIT MI
48235
US

V. Phone/Fax

Practice location:
  • Phone: 313-966-7434
  • Fax: 313-966-1738
Mailing address:
  • Phone: 313-966-7434
  • Fax: 313-966-1738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: