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Individual

MR. RAVICHANDRAN SUPPIAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
325 S BELMONT ST, YORK, PA 17403-2608
(800) 463-4326
(717) 263-1566
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5102
(703) 563-6256

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD426377
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02933397
NY
05
1014407760001
PA
Enumeration date
09/26/2005
Last updated
09/17/2015
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