Provider Demographics
NPI:1588805253
Name:MALAPUR, RAVINDRA P (MBBS,DGO,MD,ARDMS)
Entity Type:Individual
Prefix:
First Name:RAVINDRA
Middle Name:P
Last Name:MALAPUR
Suffix:
Gender:M
Credentials:MBBS,DGO,MD,ARDMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 EUREKA RD
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25314-2126
Mailing Address - Country:US
Mailing Address - Phone:304-342-0556
Mailing Address - Fax:304-342-0556
Practice Address - Street 1:250 EUREKA RD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25314-2126
Practice Address - Country:US
Practice Address - Phone:304-342-0556
Practice Address - Fax:304-342-0556
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-10
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2471S1302X2471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography