Individual
MR. MARIO EURICO RAVRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD NE, SUITE 650, ATLANTA, GA 30342-1705
(404) 459-9340
(404) 459-9347
Mailing address
5505 PEACHTREE DUNWOODY RD NE, SUITE 650, ATLANTA, GA 30342-1705
(404) 459-9340
(404) 459-9347
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
044317
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52728736
BLUE CROSS BLUE SHIELD
GA
01
—
P00059607
RAILROAD MEDICARE
—
Enumeration date
02/14/2006
Last updated
11/09/2009
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