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General NPI Number Information
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NPI Number | 1134157019
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Entity Type | Individual
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Provider Name | RAVI SRIVASTAVA MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 11/22/2023
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Provider Practice Location Address
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Address Line | 400 SENTARA CIR STE 320
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5716
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Country | US
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Telephone | 757-345-4800
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Fax | 757-345-4801
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Provider Business Mailing Address
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Address Line | 400 SENTARA CIR STE 320
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-5716
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Country | US
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Telephone | 757-345-4800
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Fax | 757-345-4801
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD.24120
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | ME103543
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 38693
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101263232
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License Number State | VA
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