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Individual

DR. RAVINDRA KUMAR VEGUNTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBBS., FRCSED.

Contact information

Practice address
1432 S DOBSON RD, SUITE 301, MESA, AZ 85202-4768
(480) 412-9400
(480) 412-9401
Mailing address
1432 S DOBSON RD, SUITE 301, MESA, AZ 85202-4768
(480) 412-9400
(480) 412-9401

Taxonomy

Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
036103187
IL
2086S0120X
Pediatric Surgery Physician
Primary
42746
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036103187
IL
01
809840
GROUP
IL
01
K33862
INDIVIDUAL
IL
Enumeration date
06/08/2006
Last updated
11/09/2010
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