Individual
MR. RAVINDER JERATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 CENTRAL AVE, SUITE 7, AUGUSTA, GA 30904-6717
(706) 736-5378
(706) 738-9922
Mailing address
2100 CENTRAL AVE, SUITE 7, AUGUSTA, GA 30904-6717
(706) 736-5378
(706) 738-9922
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
19957
GA
207VG0400X
Gynecology Physician
Primary
19957
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00233901A
—
GA
01
—
10048449
AMERIGROUP
GA
01
—
19957
STATE LICENSE
GA
01
—
342733
WELLCARE MEDICAID
GA
05
—
G19957
—
SC
Enumeration date
08/29/2006
Last updated
03/07/2023
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