Provider Demographics
NPI:1508052275
Name:RAVAL, ABHIJIT AJITKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:ABHIJIT
Middle Name:AJITKUMAR
Last Name:RAVAL
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 1:2000 E GREENVILLE ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1580
Mailing Address - Country:US
Mailing Address - Phone:864-225-5667
Mailing Address - Fax:864-716-6746
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-225-5667
Practice Address - Fax:864-716-6746
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN43740207R00000X, 208M00000X
SC33243207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810013987Medicaid
SCP00968685OtherRR MEDICARE
GA003110253AMedicaid
TN1507474Medicaid
SC332438Medicaid
KY7100051310Medicaid
KY7100051310Medicaid
GA003110253AMedicaid