Individual
RAVI NISTALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 HOSPITAL DRIVE, COLUMBIA, MO 65212-0001
(573) 882-8788
(573) 882-3131
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009007875
MO
207RN0300X
Nephrology Physician
Primary
2009007875
MO
Other
Enumeration date
09/06/2006
Last updated
09/02/2022
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