Individual
RAVDEEP S KHANUJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3001 WARRIOR LN, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
(573) 686-1029
Mailing address
3001 WARRIOR LN, P.O. BOX 280, POPLAR BLUFF, MO 63901-8685
(573) 686-1200
(573) 686-1029
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
118304
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204746812
—
MO
Enumeration date
01/17/2007
Last updated
03/17/2022
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