Provider Demographics
NPI:1124240874
Name:RAVIKUMAR, ASHA R (MD)
Entity type:Individual
Prefix:
First Name:ASHA
Middle Name:R
Last Name:RAVIKUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 N OAK ST APT 410
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22209-2607
Mailing Address - Country:US
Mailing Address - Phone:312-505-2742
Mailing Address - Fax:
Practice Address - Street 1:513 PARNASSUS AVE # HSE672
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2205
Practice Address - Country:US
Practice Address - Phone:415-476-1812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine