Organization
THREE RIVERS MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJU B RAVAL D.O. (ADMINISTRATOR)
(910) 484-5366
Entity
Organization
Contact information
Practice address
580 W. MCLEAN ST., ST. PAULS, NC 28384
(910) 865-3063
(918) 653-5063
Mailing address
580 W MCLEAN ST., ST. PAULS, NC 28384
(910) 865-3063
(910) 865-3503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
100548
NC
207R00000X
Internal Medicine Physician
Primary
9700722
NC
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89011VU
—
NC
Enumeration date
01/09/2007
Last updated
06/17/2009
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