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NPI Code Detail

MEDICARE: DEEPAK RAVINDRANATHAN

MEDICARE: DEEPAK RAVINDRANATHAN
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
1207RH0003XHematology & Oncology Physician82640GA
2207RX0202XMedical Oncology Physician82640GA
3390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1467807719
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEEPAK RAVINDRANATHAN
Provider Business Mailing Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number : 404-778-7777
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2016
Last Update Date : 12/14/2025

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Directions to “ DEEPAK RAVINDRANATHAN ” Practice Location

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