Provider Demographics
NPI:1588286991
Name:RAVINDRAN, NADISH (MD)
Entity type:Individual
Prefix:MR
First Name:NADISH
Middle Name:
Last Name:RAVINDRAN
Suffix:
Gender:M
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:CHABERT MEDICAL CENTER
Mailing Address - Street 2:1978 INDUSTRIAL BLVD
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70363
Mailing Address - Country:US
Mailing Address - Phone:985-873-2200
Mailing Address - Fax:
Practice Address - Street 1:1978 INDUSTRIAL BLVD INTERNAL MEDICINE PROGRAM
Practice Address - Street 2:CHABERT MEDICAL CENTER
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70363
Practice Address - Country:US
Practice Address - Phone:785-873-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2022-02-02
Deactivation Date:2022-01-11
Deactivation Code:
Reactivation Date:2022-02-02
Provider Licenses
StateLicense IDTaxonomies
LA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program