Individual
SRIHARI RAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25195 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Mailing address
25195 KELLY RD, SUITE A, ROSEVILLE, MI 48066-4909
(586) 775-4594
(586) 775-4506
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301058818
MI
207RI0011X
Interventional Cardiology Physician
4301058818
MI
207UN0901X
Nuclear Cardiology Physician
4301058818
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060-500-7971
BLUECROSS BLUE SHIELD
MI
01
—
OH-26467009
MEDICARE ID
MI
Enumeration date
08/12/2005
Last updated
03/07/2023
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