Provider Demographics
NPI:1669581047
Name:BALCHANDANI, RAVINA (MD)
Entity type:Individual
Prefix:
First Name:RAVINA
Middle Name:
Last Name:BALCHANDANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HOSPITAL CENTER CMNS
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2845
Mailing Address - Country:US
Mailing Address - Phone:843-682-4673
Mailing Address - Fax:843-682-4666
Practice Address - Street 1:35 HOSPITAL CENTER CMNS
Practice Address - Street 2:SUITE 101
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2845
Practice Address - Country:US
Practice Address - Phone:843-682-4673
Practice Address - Fax:843-682-4666
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31419207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02162518Medicaid
NY02162518Medicaid
SCH41902Medicare UPIN
SCAA35179734Medicare PIN
SCAA35177094Medicare PIN
NY003AQ1Medicare PIN
SCAA35176768Medicare PIN