Provider Demographics
NPI:1558316398
Name:RAVAL, DEVYANI SUBHASH (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVYANI
Middle Name:SUBHASH
Last Name:RAVAL
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 1:6110 N CAMINO DE MICHAEL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-2716
Mailing Address - Country:US
Mailing Address - Phone:520-297-0809
Mailing Address - Fax:
Practice Address - Street 1:5375 E ERICKSON DR
Practice Address - Street 2:#103
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2838
Practice Address - Country:US
Practice Address - Phone:529-292-0727
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ193902080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZE45446Medicare UPIN