Provider Demographics
NPI:1225127939
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 15278
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25365-0278
Mailing Address - Country:US
Mailing Address - Phone:304-949-1587
Mailing Address - Fax:304-949-4912
Practice Address - Street 1:8618 MACCORKLE AVE
Practice Address - Street 2:
Practice Address - City:MARMET
Practice Address - State:WV
Practice Address - Zip Code:25315-1724
Practice Address - Country:US
Practice Address - Phone:304-949-1587
Practice Address - Fax:304-949-4912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810007668Medicaid
WVD71744Medicare UPIN
WV3810007668Medicaid