Provider Demographics
NPI:1568462679
Name:CHARY, RAVI (MD)
Entity Type:Individual
Prefix:MR
First Name:RAVI
Middle Name:
Last Name:CHARY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 950161
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40295-0161
Mailing Address - Country:US
Mailing Address - Phone:502-814-3184
Mailing Address - Fax:502-814-3196
Practice Address - Street 1:6500 PRESTON HWY
Practice Address - Street 2:CHARY PRIMARY CARE PLLC
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-1820
Practice Address - Country:US
Practice Address - Phone:502-969-5995
Practice Address - Fax:502-969-5996
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY34184207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64011307Medicaid
G91224Medicare UPIN
KY64011307Medicaid