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General NPI Number Information
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NPI Number | 1891009387
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Entity Type | Individual
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Provider Name | RAVI KISHORE NARRA M.D.,
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Gender | Male
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | W180N8085 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-3518
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Country | US
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Telephone | 262-257-5100
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Fax | 262-253-7081
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Provider Business Mailing Address
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Address Line | W180N8085 TOWN HALL RD
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City | MENOMONEE FALLS
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State | WI
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Zip | 53051-3518
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Country | US
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Telephone | 262-257-5100
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Fax | 262-253-7081
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 66074
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License Number State | WI
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