Individual
DR. RAVINDRA KUMAR PATHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD, PHD, BCPS
Contact information
Practice address
500 FOOTHILL DR, VA SALT LAKE CITY HCS 119A, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1407 EMERSON AVE, SALT LAKE CITY, UT 84105-2607
(801) 582-1565
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
11779
NE
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
44923
TX
1835P1200X
Pharmacotherapy Pharmacist
Primary
11779
NE
1835P1300X
Psychiatric Pharmacist
11779
NE
Other
Enumeration date
06/23/2005
Last updated
12/14/2009
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