Provider Demographics
NPI:1659334373
Name:KOHLI, RAVINDER SINGH (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVINDER
Middle Name:SINGH
Last Name:KOHLI
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 1:89 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLONIAL HEIGHTS
Mailing Address - State:VA
Mailing Address - Zip Code:23834-1447
Mailing Address - Country:US
Mailing Address - Phone:804-526-3010
Mailing Address - Fax:804-526-2293
Practice Address - Street 1:89 SHERWOOD DR
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-1447
Practice Address - Country:US
Practice Address - Phone:804-526-3010
Practice Address - Fax:804-526-2293
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101047753207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE58726Medicare UPIN