Provider Demographics
NPI:1720242183
Name:KANT, RAVI (MBBS)
Entity Type:Individual
Prefix:DR
First Name:RAVI
Middle Name:
Last Name:KANT
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 262
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29622-0262
Mailing Address - Country:US
Mailing Address - Phone:864-512-4160
Mailing Address - Fax:864-512-4165
Practice Address - Street 1:100 HEALTHY WAY STE 1210
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-512-4160
Practice Address - Fax:864-512-4165
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP22874207R00000X
SC37083207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC370832Medicaid
SC370832Medicaid