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General NPI Number Information
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NPI Number | 1356580179
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Entity Type | Organization
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Legal Business Name | RAVINDER NATH, M.D. INC.
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 03/16/2012
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Provider Practice Location Address
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Address Line | 1280 BOARDMAN CANFIELD RD
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City | BOARDMAN
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State | OH
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Zip | 44512-4073
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Country | US
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Telephone | 330-726-9582
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Fax | 330-726-9769
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Provider Business Mailing Address
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Address Line | 1280 BOARDMAN CANFIELD RD
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City | BOARDMAN
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State | OH
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Zip | 44512-4073
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Country | US
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Telephone | 330-726-9582
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Fax | 330-726-9769
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KATHLEEN M CARLSON
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Credential |
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Telephone | 330-726-9582
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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 | 35042959N
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License Number State | OH
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