Individual
RAVINDRA K GOGINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1021 QUARRIER ST, STE 301, CHARLESTON, WV 25301-2313
(304) 343-4625
(304) 343-4626
Mailing address
1021 QUARRIER ST, STE 301, CHARLESTON, WV 25301-2313
(304) 343-4625
(304) 343-4626
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
12675
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718792
BLUE CROSS
WV
05
—
0123331000
—
WV
Enumeration date
06/01/2005
Last updated
09/07/2012
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