Organization
DR K RAVILOCHAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMASAMUDRAM RAVILOCHAN M.D. (NEUROLOGIST)
(303) 730-8277
Entity
Organization
Contact information
Practice address
7720 S BROADWAY STE 320, LITTLETON, CO 80122-2624
(303) 730-8277
(303) 730-1868
Mailing address
7720 S BROADWAY STE 320, LITTLETON, CO 80122-2624
(303) 730-8277
(303) 730-1868
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09158561
—
CO
01
—
C801075
MEDICARE GROUP
CO
Enumeration date
04/23/2007
Last updated
12/14/2007
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