Provider Demographics
NPI:1811196405
Name:MARFATIA, RAVI S (MD)
Entity Type:Individual
Prefix:
First Name:RAVI
Middle Name:S
Last Name:MARFATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 48089
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-8089
Mailing Address - Country:US
Mailing Address - Phone:706-389-3740
Mailing Address - Fax:706-389-3951
Practice Address - Street 1:2470 DANIELS BRIDGE RD
Practice Address - Street 2:BLDG 200, SUITE 251
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-6187
Practice Address - Country:US
Practice Address - Phone:706-389-3440
Practice Address - Fax:706-353-2205
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA076901207RC0000X, 207RC0000X
CT46710208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist