Provider Demographics
NPI:1497877377
Name:SINGH, RAVIKUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVIKUMAR
Middle Name:
Last Name:SINGH
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 1:245 ST HELENS AVE # 108
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-2594
Mailing Address - Country:US
Mailing Address - Phone:901-218-3035
Mailing Address - Fax:855-292-0966
Practice Address - Street 1:GRAYS HARBOR COMMUNITY HOSPITAL
Practice Address - Street 2:915 ANDERSON DRIVE
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520
Practice Address - Country:US
Practice Address - Phone:360-532-8330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5283207P00000X
AR390200000X
TNMD43771207Q00000X
ARE5283207Q00000X
WAMD61030731207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1506376Medicaid