Individual
DR. RAVALI BANDARU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2308 E MAIN ST, SUITE G, NEW IBERIA, LA 70560-4041
(337) 367-2001
(337) 365-3050
Mailing address
401 YOUNGSVILLE HWY, SUITE 100, LAFAYETTE, LA 70508-5173
(337) 330-0031
(337) 330-0059
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
207012
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2372874
—
LA
Enumeration date
07/29/2014
Last updated
09/13/2016
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