Individual
TIRUVADI RAVIGURURAJAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2318 E CENTRAL AVE, WICHITA, KS 67214-4436
(316) 262-3611
(316) 262-0741
Mailing address
2318 E CENTRAL AVE, WICHITA, KS 67214-4436
(316) 262-3611
(316) 262-0741
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
15-01080
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
427015
BCBS
KS
Enumeration date
09/22/2006
Last updated
07/08/2007
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