Provider Demographics
NPI:1033438544
Name:CHHATRALA, RAVI (MBBS)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:CHHATRALA
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11803 JEFFERSON AVE
Mailing Address - Street 2:SUITE 230
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-2565
Mailing Address - Country:US
Mailing Address - Phone:757-534-7701
Mailing Address - Fax:757-534-7708
Practice Address - Street 1:11803 JEFFERSON AVE
Practice Address - Street 2:SUITE 230
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2565
Practice Address - Country:US
Practice Address - Phone:757-534-7701
Practice Address - Fax:757-534-7708
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101255010207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program