Provider Demographics
NPI:1336484013
Name:RAVINDRAN, BHANU (MD)
Entity Type:Individual
Prefix:DR
First Name:BHANU
Middle Name:
Last Name:RAVINDRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3723 53RD AVE
Mailing Address - Street 2:SPRINGS AT BETTENDORF
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-1191
Mailing Address - Country:US
Mailing Address - Phone:563-823-8404
Mailing Address - Fax:
Practice Address - Street 1:2701, 17TH ST
Practice Address - Street 2:TRINITY MEDICAL CENTRE
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201
Practice Address - Country:US
Practice Address - Phone:309-779-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.131659207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine