Provider Demographics
NPI:1649508631
Name:MADINENI, RAVI CHANDRA ANJANEYALU (MD)
Entity type:Individual
Prefix:DR
First Name:RAVI CHANDRA
Middle Name:ANJANEYALU
Last Name:MADINENI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:830 OLD LANCASTER RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3118
Mailing Address - Country:US
Mailing Address - Phone:610-525-1061
Mailing Address - Fax:610-525-3509
Practice Address - Street 1:830 OLD LANCASTER RD
Practice Address - Street 2:SUITE 209
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3118
Practice Address - Country:US
Practice Address - Phone:610-525-1061
Practice Address - Fax:610-525-3509
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2017-03-01
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Provider Licenses
StateLicense IDTaxonomies
PAMD459497207T00000X
IL125057261207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery