Organization
MARIO RAVRY, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO RAVRY M.D. (PHYSICIAN/PARTNER)
(404) 459-9340
Entity
Organization
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD NE, SUITE 650, ATLANTA, GA 30342-1705
(404) 459-9340
(404) 459-9347
Mailing address
5505 PEACHTREE DUNWOODY RD NE, SUITE 650, ATLANTA, GA 30342-1705
(404) 459-9340
(404) 459-9347
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA4579
RAILROAD MEDICARE
—
Enumeration date
02/14/2006
Last updated
11/09/2009
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