Provider Demographics
NPI:1730114943
Name:PADMANABHAN, RAVINDRAN ARCOT (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVINDRAN
Middle Name:ARCOT
Last Name:PADMANABHAN
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 1:2021 MILL GATE LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-7195
Mailing Address - Country:US
Mailing Address - Phone:919-270-5082
Mailing Address - Fax:
Practice Address - Street 1:2460 CURTIS ELLIS DR BLDG 300
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2237
Practice Address - Country:US
Practice Address - Phone:252-962-4290
Practice Address - Fax:252-962-4291
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35086165207RI0200X
WI81513-20207RI0200X
NC2010-01390207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5915761Medicaid