Individual
DR. ABINAYAA PURUSHOTHAMAN RAVICHANDRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1804 CHUCKWA DR, DURANT, OK 74701-2146
(903) 893-5141
Mailing address
1503 SHETLAND DR, ALLEN, TX 75013-5876
(469) 994-2395
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
38584
OK
390200000X
Student in an Organized Health Care Education/Training Program
MT212915
PA
Other
Enumeration date
06/22/2017
Last updated
08/09/2024
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