Individual
NONE VIMAL RAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 S NATIONAL AVE STE 510, SPRINGFIELD, MO 65807
(417) 875-3160
Mailing address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3462
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT203127
PA
207RP1001X
Pulmonary Disease Physician
Primary
2019017130
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070363
—
MO
Enumeration date
08/14/2013
Last updated
04/08/2026
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