Provider Demographics
NPI:1003870841
Name:RAVICK, ARNOLD S (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:S
Last Name:RAVICK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1145 19TH ST NW
Mailing Address - Street 2:SUITE #409
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3701
Mailing Address - Country:US
Mailing Address - Phone:301-455-3566
Mailing Address - Fax:202-296-2531
Practice Address - Street 1:1145 19TH STREET, N.W.
Practice Address - Street 2:SUITE 409
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3716
Practice Address - Country:US
Practice Address - Phone:202-223-0500
Practice Address - Fax:202-296-2531
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2017-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPO326213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC480013906OtherRR MEDICARE INDIVIDUAL PROVIDER #
DC480013906OtherRR MEDICARE INDIVIDUAL PROVIDER #
DC111445C11Medicare PIN