Provider Demographics
NPI:1942317482
Name:KONDAVEETI, RAVI (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:
Last Name:KONDAVEETI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1350 LOCUST ST. SUITE 208
Mailing Address - Street 2:RAVI GI ASSOCIATES LLP
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219
Mailing Address - Country:US
Mailing Address - Phone:412-621-0220
Mailing Address - Fax:412-621-5486
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:STE. 453
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-1907
Practice Address - Fax:412-621-5486
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2011-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI45781207R00000X
IL036102902207RG0100X
PAMD442416207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD442416OtherLICENSE