Provider Demographics
NPI:1699989012
Name:RAVNIC, DINO (DO)
Entity type:Individual
Prefix:
First Name:DINO
Middle Name:
Last Name:RAVNIC
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:H071
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-8372
Mailing Address - Fax:717-531-4339
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:H071
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-8372
Practice Address - Fax:717-531-4339
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS013530208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery