Provider Demographics
NPI:1588606701
Name:SHEKARAPPA, RAVINDRAPRASAD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVINDRAPRASAD
Middle Name:J
Last Name:SHEKARAPPA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:623 S HOUSTON LAKE RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-9093
Mailing Address - Country:US
Mailing Address - Phone:478-333-6977
Mailing Address - Fax:478-333-6973
Practice Address - Street 1:623 S HOUSTON LAKE RD
Practice Address - Street 2:SUITE 500
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-9093
Practice Address - Country:US
Practice Address - Phone:478-333-6977
Practice Address - Fax:478-333-6973
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2013-02-01
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Provider Licenses
StateLicense IDTaxonomies
GA047262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000874123FMedicaid
GAH15603Medicare UPIN
GA11SCDMTMedicare PIN