Provider Demographics
NPI:1780652867
Name:SARIN, RAVI R (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:R
Last Name:SARIN
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:PO BOX 506
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47396-0506
Mailing Address - Country:US
Mailing Address - Phone:765-298-4120
Mailing Address - Fax:765-751-3377
Practice Address - Street 1:3025 N OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-2261
Practice Address - Country:US
Practice Address - Phone:765-298-4120
Practice Address - Fax:765-751-3377
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01042569A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100413220BMedicaid
IN200112430Medicaid
E75347Medicare UPIN