Provider Demographics
NPI:1912986423
Name:RAVICHANDER, PINJAI RAMADAS (MD)
Entity Type:Individual
Prefix:
First Name:PINJAI
Middle Name:RAMADAS
Last Name:RAVICHANDER
Suffix:
Gender:M
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:PO BOX 26683
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29616-1683
Mailing Address - Country:US
Mailing Address - Phone:864-244-6777
Mailing Address - Fax:864-244-4212
Practice Address - Street 1:4210 E NORTH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-2423
Practice Address - Country:US
Practice Address - Phone:864-244-6777
Practice Address - Fax:864-244-4212
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC16415207R00000X, 207RH0000X, 207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC164155Medicaid
SCF50375Medicare UPIN