Individual
SAMUEL DUBOSE RAVENEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1814 WESTCHESTER DRIVE, SUITE 203, HIGH POINT, NC 27262-3832
(336) 802-2100
(336) 802-2101
Mailing address
1701 WESTCHESTER DRIVE, SUITE 850, HIGH POINT, NC 27262-7254
(336) 802-2400
(336) 802-2534
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14283
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8970539
—
NC
Enumeration date
05/31/2006
Last updated
03/22/2010
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