Provider Demographics
NPI:1396973178
Name:AGRAWAL, RAVI (MBBS)
Entity type:Individual
Prefix:
First Name:RAVI
Middle Name:
Last Name:AGRAWAL
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:834 EATON AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1832
Mailing Address - Country:US
Mailing Address - Phone:484-526-7780
Mailing Address - Fax:833-816-7518
Practice Address - Street 1:834 EATON AVE STE 301
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1832
Practice Address - Country:US
Practice Address - Phone:484-526-7780
Practice Address - Fax:833-816-7518
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD446071207R00000X, 207RN0300X
NJ25MA10257500207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine