Subhaschandra R Ravi MD PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301037460 Issued in MI

Legal business name

SUBHASCHANDRA R RAVI MD PLLC

Practice address

30 W Main St
Hartford, MI 49057-1005

Phone

(269) 621-2166

Fax

(269) 621-2566

NPI assigned

Jul 30, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Prabha Reddy Ravi

Title

Office Manager

Phone

(269) 621-2166

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280448000000",
    "number": "1285948463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490578730",
            "telephone_number": "269-621-2166",
            "fax_number": "269-621-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W MAIN ST",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490571005",
            "telephone_number": "269-621-2166",
            "fax_number": "269-621-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBHASCHANDRA R RAVI MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-30",
        "last_updated": "2010-07-30",
        "status": "A",
        "authorized_official_last_name": "RAVI",
        "authorized_official_first_name": "PRABHA",
        "authorized_official_middle_name": "REDDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "269-621-2166",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301037460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790118",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Schrock, RDH
• Seth Griffin DDS PLLC (Hartford Family Dental Care)
• Jay Shah, M.D.
• Sandra Lynn Sharp, SOCIAL SERVICE TECHN
• Michael Noel Sila, RPH,PHARMD
• Ann Marie Tapper, FNP-C
• Van Buren Cass District Health Department
• Van Buren Cass District Public Health Dept
• Van Buren Community Mental Health Authority
• Van Buren Community Mental Health Authority

• General Practice Physician in Hartford, MI
• Providers in Hartford, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.