Provider Demographics
NPI:1457351579
Name:RAVI CHARY MD PLLC
Entity Type:Organization
Organization Name:RAVI CHARY MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:M V
Authorized Official - Last Name:CHARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-969-5995
Mailing Address - Street 1:6500 PRESTON HWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-1820
Mailing Address - Country:US
Mailing Address - Phone:502-969-5995
Mailing Address - Fax:502-969-5996
Practice Address - Street 1:6500 PRESTON HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219
Practice Address - Country:US
Practice Address - Phone:502-969-5995
Practice Address - Fax:502-969-5996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY65938003Medicaid
KY0774901Medicare PIN