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General NPI Number Information
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NPI Number | 1043304249
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Entity Type | Individual
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Provider Name | NEIL DOUGLAS RAVIN MD
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 05/01/2014
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Provider Practice Location Address
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Address Line | 62 BROWN ST SUITE 303
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City | HAVERHILL
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State | MA
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Zip | 01830-6778
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Country | US
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Telephone | 978-478-5030
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Fax | 978-377-0412
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Provider Business Mailing Address
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Address Line | 62 BROWN ST SUITE 303
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City | HAVERHILL
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State | MA
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Zip | 01830-6778
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Country | US
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Telephone | 978-478-5030
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Fax | 978-377-0412
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D26704
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 13807
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License Number State | NH
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