Provider Demographics
NPI:1366658627
Name:RANAWAT, NISHANT SINGH (MD)
Entity type:Individual
Prefix:DR
First Name:NISHANT
Middle Name:SINGH
Last Name:RANAWAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1553 DEVONSHIRE PL
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-7201
Mailing Address - Country:US
Mailing Address - Phone:216-396-7455
Mailing Address - Fax:
Practice Address - Street 1:9180 PINECROFT DR STE 500
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3883
Practice Address - Country:US
Practice Address - Phone:713-897-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD1923982085R0204X, 2084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU2614OtherTEXAS MEDICAL BOARD
TX92-0807868OtherSUNBELT NEUROLOGICAL SERVICES