Individual
DR. JAYASHREE RAVISHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1236 HUFFMAN MILL RD, BURLINGTON, NC 27215-8700
(336) 538-8760
Mailing address
5855 BREMO RD STE 306, MOB NORTH, RICHMOND, VA 23226-1923
(804) 287-7650
(804) 287-7642
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
0101251651
VA
207RI0200X
Infectious Disease Physician
Primary
201901489
NC
207RI0200X
Infectious Disease Physician
232767-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02219074
—
NY
01
—
C06778
GROUP PTAN
VA
Enumeration date
09/13/2005
Last updated
09/20/2021
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