Provider Demographics
NPI:1699138818
Name:RAVAL, KUNIL KAUSHIK (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:KUNIL
Middle Name:KAUSHIK
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 LUMBERMEN WAY
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-8627
Mailing Address - Country:US
Mailing Address - Phone:608-354-9637
Mailing Address - Fax:
Practice Address - Street 1:540 E CANFIELD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-1928
Practice Address - Country:US
Practice Address - Phone:313-577-1102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program