Provider Demographics
NPI:1235116377
Name:RAVINDRA, PINDIPAPANAHALLI V (MD)
Entity Type:Individual
Prefix:
First Name:PINDIPAPANAHALLI
Middle Name:V
Last Name:RAVINDRA
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 1:8243 MEADOWBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2329
Mailing Address - Country:US
Mailing Address - Phone:804-730-1481
Mailing Address - Fax:804-730-8464
Practice Address - Street 1:8243 MEADOWBRIDGE RD
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-2329
Practice Address - Country:US
Practice Address - Phone:804-730-1481
Practice Address - Fax:804-730-8464
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101054972207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC06115OtherGROUP PTAN
VA005800366Medicaid
VA005800366Medicaid
060000928Medicare ID - Type Unspecified