Provider Demographics
NPI:1710958434
Name:DUKKIPATI, RAVI (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:DUKKIPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-5503
Mailing Address - Fax:717-851-5507
Practice Address - Street 1:1695 ROOSEVELT AVE STE B
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17408-8521
Practice Address - Country:US
Practice Address - Phone:717-851-5503
Practice Address - Fax:717-798-3510
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD070868L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA720584OtherUPMC-WMG
PA001797173Medicaid
PA1512166OtherGATEWAY-WMG
PA389441OtherUNITED HEALTH CARE COMM PLAN-WMG
PA30083728OtherAMERIHEALTH MERCY-WMG
PA971315OtherCAREFIRST MD BCBS-WMG
PA012032OtherHIGHMARK BLUE SHIELD-WMG
PA037379FLTMedicare PIN
PA30083728OtherAMERIHEALTH MERCY-WMG
PA1512166OtherGATEWAY-WMG
H14638Medicare UPIN
PAP00932645Medicare PIN