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Organization

JOHN S. RAVITA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN SALVATORE RAVITA M.D. (DIRECTOR OF RADIATION MEDICINE)
(803) 791-2598
Entity
Organization

Contact information

Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2598
(803) 791-2577
Mailing address
104 WINDSONG ISLAND LN, COLUMBIA, SC 29212-8329
(803) 791-2598
(803) 791-2577

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
8174
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA5958
SC
Enumeration date
04/03/2007
Last updated
08/22/2020
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