Provider Demographics
NPI:1538410006
Name:RAVAL, BHRUGAV G (MD)
Entity type:Individual
Prefix:DR
First Name:BHRUGAV
Middle Name:G
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:920 STANTON L YOUNG BLVD STE 2040
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5036
Mailing Address - Country:US
Mailing Address - Phone:405-271-4113
Mailing Address - Fax:405-271-5723
Practice Address - Street 1:825 NE 10TH ST STE 5B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104
Practice Address - Country:US
Practice Address - Phone:405-271-3635
Practice Address - Fax:405-271-2523
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4571892084N0400X
OK333642084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology