Individual
DR. RAVISHANKAR SHIVASHANKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST # G2K14, BALTIMORE, MD 21201-1544
(410) 328-5112
(410) 328-3168
Mailing address
22 S GREENE ST # G2K14, BALTIMORE, MD 21201-1544
(410) 328-5112
(410) 328-3168
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
57.019086
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/16/2011
Last updated
02/07/2014
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