Individual
RAVINDER SURAKANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1704 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1071
(765) 364-1252
Mailing address
1710 LAFAYETTE RD, CRAWFORDSVILLE, IN 47933-1033
(765) 361-3012
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01034655A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000093742
ANTHEM ID #
IN
05
—
100185610A
—
IN
Enumeration date
11/14/2006
Last updated
12/20/2012
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