Individual
DR. RAVI VARMA DATLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101243191
VA
390200000X
Student in an Organized Health Care Education/Training Program
MT186124
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053596270
—
VA
01
—
302011
ANTHEM
VA
01
—
4195775
CIGNA
—
01
—
P00729695
RAILROAD MEDICARE
VA
Enumeration date
01/07/2008
Last updated
06/07/2021
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