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Individual

RAVI VIJAY SHAMAIENGAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2912
(410) 740-7544
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101056474
VA
2085R0202X
Diagnostic Radiology Physician
Primary
D96224
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7223170
VA
Enumeration date
08/11/2006
Last updated
09/05/2024
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