Individual
DR. RAVINDER K. WALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 334-3155
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
295408
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0061702400
—
MD
05
—
5852170
—
VA
01
—
708035-01
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
06/12/2006
Last updated
11/17/2022
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