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General NPI Number Information
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NPI Number | 1134673742
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Entity Type | Individual
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Provider Name | RAVALI JAGATA
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Gender | Female
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 03/02/2026
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Provider Practice Location Address
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Address Line | 1204 WESTERLEE PL APT 1A
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City | CATONSVILLE
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State | MD
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Zip | 21228-3727
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Country | US
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Telephone | 484-949-2229
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 WESTERLEE PL APT 1A
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City | CATONSVILLE
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State | MD
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Zip | 21228-3727
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Country | US
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Telephone | 484-949-2229
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Fax |
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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 | P33503
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 64973
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License Number State | TN
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