Organization
ANU RAVIKANTH MD LLC DBA-INTERNAL MEDICINE OF MARIETTA
Active
Other names
Internal Medicine Of Marietta
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANUPAMA RAVIKANTH M.D. (OWNER)
(770) 771-5470
Entity
Organization
Contact information
Practice address
140 VANN STREET NE, SUITE 350, MARIETTA, GA 30060
(770) 771-5470
(770) 771-5471
Mailing address
140 VANN STREET NE, SUITE 350, MARIETTA, GA 30060
(770) 771-5470
(770) 771-5471
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
048297
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184719122
PROVIDER NPI
GA
Enumeration date
08/28/2010
Last updated
01/15/2014
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