Individual
DR. RAJAN RAMESH REVANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
2630 WILLARD DAIRY RD STE 301, HIGH POINT, NC 27265-8354
(336) 884-3720
Mailing address
1701 WESTCHESTER DR, STE 850, HIGH POINT, NC 27262-7254
(336) 802-2400
(336) 802-2001
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9900659
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912054
—
NC
01
—
P00655198
RR MEDICARE
NC
Enumeration date
01/09/2007
Last updated
08/25/2021
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