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Individual

RAVINDRANATH V. KANTAMNENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
207 HAVEN DR, DOTHAN, AL 36301-2919
(334) 793-3319
(334) 793-2291
Mailing address
207 HAVEN DR, DOTHAN, AL 36301-2919

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
21365
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000076333
AL
01
051076333
BLUE CROSS BLUE SHIELD
AL
Enumeration date
05/12/2006
Last updated
04/14/2025
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