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)CodeLicenseStatePrimary
Interventional Cardiology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Moberly, MO

All providers in Moberly, MO · Interventional Cardiology Physician in Missouri

Sources for this page

Verify at the official NPI Registry.