Provider Demographics
NPI:1467494021
Name:VARANASI, RAVIKANT V (MD)
Entity Type:Individual
Prefix:
First Name:RAVIKANT
Middle Name:V
Last Name:VARANASI
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 1:205 PAGE RD
Mailing Address - Street 2:
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8798
Mailing Address - Country:US
Mailing Address - Phone:910-295-5511
Mailing Address - Fax:910-235-3432
Practice Address - Street 1:15 REGIONAL DR
Practice Address - Street 2:
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8850
Practice Address - Country:US
Practice Address - Phone:910-295-9207
Practice Address - Fax:910-235-3432
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2002-00618207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC100016195OtherPALMETTO GBA PROVIDER#
NCFH2001075OtherFIRSTCAROLINACARE PROV.#
NC131FNOtherBC/BS NC PROVIDER#
NC89131FNMedicaid
NC2900520OtherEVERCARE
SCN00613OtherSC MEDICAID PROVIDER#
NCB6596OtherMEDCOST PROVIDER#
H46781Medicare UPIN
NC2002835Medicare ID - Type Unspecified