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General NPI Number Information
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NPI Number | 1841668951
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Entity Type | Organization
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Legal Business Name | SRIKANTH RAVINDRAN MD INC
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Dates
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Enumeration Date | 09/04/2015
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Last Update Date | 07/27/2016
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Provider Practice Location Address
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Address Line | 10380 SUTTON PL
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City | MUNSTER
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State | IN
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Zip | 46321-2882
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Country | US
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Telephone | 630-863-8575
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Fax |
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Provider Business Mailing Address
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Address Line | 10380 SUTTON PL
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City | MUNSTER
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State | IN
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Zip | 46321-2882
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Country | US
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Telephone | 630-863-8575
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SRIKANTH RAVINDRAN
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Credential | M.D.
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Telephone | 630-863-8575
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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