Provider Demographics
NPI:1093058018
Name:MISHRA, RAVI PRASHANT (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:PRASHANT
Last Name:MISHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 PATTERSON ST STE 311
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-6533
Mailing Address - Country:US
Mailing Address - Phone:615-342-6830
Mailing Address - Fax:
Practice Address - Street 1:2400 PATTERSON ST STE 311
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-6533
Practice Address - Country:US
Practice Address - Phone:615-342-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN54795208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist