Healthcare Provider Details

I. General information

NPI: 1033850698
Provider Name (Legal Business Name): MANISHA RAVI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2022
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MEDICAL CENTER DR
NASHVILLE TN
37232-0028
US

IV. Provider business mailing address

719 THOMPSON LN STE 26300
NASHVILLE TN
37204-4679
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-5000
  • Fax:
Mailing address:
  • Phone: 615-322-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number77757
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: