Individual
SUSHMA RAVIRALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
41 MALL RD, BURLINGTON, MA 01805-1716
(781) 744-8000
Mailing address
PROVIDER ENROLLMENT 41 MALL ROAD, BURLINGTON, MA 01805-0001
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1012998
MA
Other
Enumeration date
07/07/2017
Last updated
12/20/2023
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