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Individual

DR. CHICKAMAGALUR N RAVEESH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3409 LUDINGTON ST STE 203, ESCANABA, MI 49829-4213
(906) 786-5707
(906) 789-4446
Mailing address
3409 LUDINGTON ST STE 203, ESCANABA, MI 49829-4213
(906) 786-5707
(906) 789-4446

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301068941
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110127992
RAILROAD MEDICARE
MI
05
3286162
MI
01
381358036014
TRICARE
MI
Enumeration date
09/12/2005
Last updated
07/14/2009
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