=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578670600
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RAVI P SARMA M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2006
-----------------------------------------------------
Last Update Date | 12/06/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2041 GEORGIA AVE NW STE 5100
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-865-6625
-----------------------------------------------------
Fax | 202-865-6457
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2041 GEORGIA AVE NW TOWER 6101
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20060-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-865-6679
-----------------------------------------------------
Fax | 202-865-3138
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | 18073
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | MD047108
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------