MEDICARE: MR. YAGNESH RAMESHWAR RAVAL MD.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	35039360	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	300029983	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043265234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. YAGNESH RAMESHWAR RAVAL MD.

Provider Business Mailing Address
First Line	:	2952 SHAWNEE TRAIL
Second Line	:
City	:	PIQUA
State	:	OH
Zip	:	45356-9709
Country	:	US
Telephone Number	:	937-773-2482
Fax Number	:	937-440-4381

Provider Business Practice Location Address
First Line	:	3130 NORTH DIXIE HIGHWAY
Second Line	:	IMAGING DEPARTMENT
City	:	TROY
State	:	OH
Zip	:	45373-1309
Country	:	US
Telephone Number	:	937-440-4800
Fax Number	:	937-440-4381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	05/30/2012

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