Individual
RAVI VARMA GOTTUMUKKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 FRUIT ST., RADIOLOGY, BOSTON, MA 02114
(630) 291-9085
Mailing address
4 LONGFELLOW PL APT 2009, BOSTON, MA 02114-2817
(630) 291-9085
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
273231
MA
Other
Enumeration date
06/19/2014
Last updated
05/08/2019
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