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General NPI Number Information
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NPI Number | 1790969657
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Entity Type | Organization
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Legal Business Name | MAHIPAL RAVIPATI
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 2426 DANVILLE RD SW STE P
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City | DECATUR
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State | AL
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Zip | 35603-4294
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Country | US
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Telephone | 256-350-1965
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Fax | 256-351-5146
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Provider Business Mailing Address
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Address Line | 2426 DANVILLE RD SW STE P
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City | DECATUR
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State | AL
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Zip | 35603-4294
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Country | US
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Telephone | 256-350-1965
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Fax | 256-351-5146
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Authorized Official
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Title or Position | MD
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Name | MAHIPAL RAVIPATI
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Credential | M.D.
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Telephone | 256-350-1965
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number |
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License Number State |
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