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NPI Code Detail

MEDICARE: PRACHI J RAVAL

MEDICARE:   PRACHI J RAVAL
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
1183500000XPharmacist5302043283MI

General Provider Information

NPI Number : 1376174060
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRACHI J RAVAL
Provider Business Mailing Address
First Line : 18157 CANVASBACK DR
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038-1188
Country : US
Telephone Number : 586-996-8779
Fax Number :
Provider Business Practice Location Address
First Line : 2011 S ROCHESTER RD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48307-3857
Country : US
Telephone Number : 248-844-2559
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2020
Last Update Date : 01/31/2020

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Directions to “ PRACHI J RAVAL ” Practice Location

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