Organization
RAVI K TITHA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVI K TITHA MD (PHYSICIAN)
(276) 964-6711
Entity
Organization
Contact information
Practice address
3150 CLINCH ST, RICHLANDS, VA 24641-2172
(276) 964-6711
(276) 964-2240
Mailing address
3150 CLINCH ST, RICHLANDS, VA 24641-2172
(276) 964-6711
(276) 964-2240
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0101235493
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010063671
—
VA
01
—
010163800
FEDERAL BLACK LUNG
VA
01
—
164419
BLUECROSS BLUESHEILD
VA
Enumeration date
06/26/2008
Last updated
10/24/2008
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