Centric Outpatient Cath Lab LLC
Organization Active NPI Interventional Cardiology Physician · Moberly, MO
NPI 1306340997 · NPPES record last updated Mar 20, 2018
Key facts
- NPI
- 1306340997
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Interventional Cardiology Physician 207RI0011X
- License
- 2002015751 (MO)
- Legal business name
- CENTRIC OUTPATIENT CATH LAB LLC
- Practice address
- 2103 Silva LN
Moberly, MO 65270-3660 - Phone
- (660) 616-0022
- NPI assigned
- Mar 20, 2018
- Organization subpart
- No
Authorized official
- Name
- Dr. Sanjeev Dhari Ravipudi, MD
- Title
- Owner
- Phone
- (626) 394-6299
National Provider Directory
Locations
2103 Silva Ln
#L
Moberly, MO 65270
Phone (626) 394-6299
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Interventional Cardiology Physician |
207RI0011X | 2002015751 | MO | Yes |
Addresses
Primary practice location
2103 Silva LN
Moberly, MO 65270-3660
Mailing address
2103 Silva LN
Moberly, MO 65270-3660
Phone (660) 616-0022
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All providers in Moberly, MO · Interventional Cardiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.