Individual
RAVINDER MEDIRATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1514 W MILHAM AVE, PORTAGE, MI 49024-1296
(269) 342-0606
(269) 342-0919
Mailing address
1514 W MILHAM AVE, PORTAGE, MI 49024-1296
(269) 342-0606
(269) 342-0919
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
4301052512
MI
2084P0800X
Psychiatry Physician
Primary
4301052512
MI
2084P0804X
Child & Adolescent Psychiatry Physician
430152512
MI
Other
Enumeration date
10/26/2006
Last updated
12/31/2012
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