Individual
RAVISANKAR R AVVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2703 HENRY ST, GREENSBORO, NC 27405-3669
(336) 621-8911
(336) 621-6322
Mailing address
PO BOX 14944, GREENSBORO, NC 27415-4944
(336) 621-8911
(336) 621-6322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
9701235
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7910402
—
NC
Enumeration date
07/12/2006
Last updated
07/08/2007
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