Provider Demographics
NPI:1962733949
Name:RAVAL, RAJU RASIK (MD, DPHIL)
Entity type:Individual
Prefix:DR
First Name:RAJU
Middle Name:RASIK
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD, DPHIL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-8415
Mailing Address - Fax:614-366-8707
Practice Address - Street 1:460 W 10TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-8415
Practice Address - Fax:614-366-8707
Is Sole Proprietor?:No
Enumeration Date:2010-01-14
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH351232482085R0001X
MDP261822085R0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program