Provider Demographics
NPI:1164511846
Name:RAVIN & NILIMA BHIRUD MDS
Entity Type:Organization
Organization Name:RAVIN & NILIMA BHIRUD MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NILIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:NARKHEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-949-1587
Mailing Address - Street 1:PO BOX 539
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:WV
Mailing Address - Zip Code:25136-0539
Mailing Address - Country:US
Mailing Address - Phone:304-442-2569
Mailing Address - Fax:304-442-2569
Practice Address - Street 1:401 6TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:WV
Practice Address - Zip Code:25136-2116
Practice Address - Country:US
Practice Address - Phone:304-442-2569
Practice Address - Fax:304-442-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810007667Medicaid
WV8804522Medicare PIN
WV3810007667Medicaid