Provider Demographics
NPI:1235715004
Name:RANAVAYA, MOHAMMED IQBAL II
Entity Type:Individual
Prefix:
First Name:MOHAMMED
Middle Name:IQBAL
Last Name:RANAVAYA
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6470 MERRICK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-9739
Mailing Address - Country:US
Mailing Address - Phone:304-617-6893
Mailing Address - Fax:
Practice Address - Street 1:6470 MERRICK CREEK RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-9739
Practice Address - Country:US
Practice Address - Phone:304-617-6893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program