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General NPI Number Information
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NPI Number | 1629312871
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Entity Type | Individual
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Provider Name | ANANDA KUMAR RAVIPATI RPH
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Gender | Male
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Dates
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Enumeration Date | 11/11/2012
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Last Update Date | 11/11/2012
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Provider Practice Location Address
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Address Line | 1251 W PRATT ST
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City | BALTIMORE
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State | MD
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Zip | 21223-2665
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Country | US
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Telephone | 410-209-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 4 ROMAN KNOLL CT APT A
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City | COCKEYSVILLE
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State | MD
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Zip | 21030-4030
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Country | US
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Telephone | 609-902-8780
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21148
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License Number State | MD
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