Individual
SALLY RAVANOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-7093
(919) 784-7395
Mailing address
4420 LAKE BOONE TRL, RALEIGH, NC 27607-7505
(919) 784-7093
(919) 784-7395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2009-00012
NC
208000000X
Pediatrics Physician
2009-00012
NC
Other
Enumeration date
05/01/2007
Last updated
03/24/2021
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