Individual
RAVI GURUSAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 266-1490
(423) 778-2108
Mailing address
975 E 3RD ST, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-2147
(423) 266-1490
(423) 778-2108
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
51353
TN
207R00000X
Internal Medicine Physician
MT194224
PA
Other
Enumeration date
07/30/2009
Last updated
10/15/2014
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