Provider Demographics
NPI:1992071096
Name:GILL, RAVINDERPAL K (MD)
Entity type:Individual
Prefix:DR
First Name:RAVINDERPAL
Middle Name:K
Last Name:GILL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 ADAMS DR STE B
Mailing Address - Street 2:
Mailing Address - City:DEMOREST
Mailing Address - State:GA
Mailing Address - Zip Code:30535-4578
Mailing Address - Country:US
Mailing Address - Phone:706-842-7571
Mailing Address - Fax:706-842-6173
Practice Address - Street 1:225 ADAMS DR STE B
Practice Address - Street 2:
Practice Address - City:DEMOREST
Practice Address - State:GA
Practice Address - Zip Code:30535-4578
Practice Address - Country:US
Practice Address - Phone:706-842-7571
Practice Address - Fax:706-842-6173
Is Sole Proprietor?:No
Enumeration Date:2012-03-22
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262747-01207R00000X
VA0101262584207R00000X
GA069198207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine