Mahidhar, Ravilla L
Mahidhar, Ravilla L is an individual health care provider with primary practice located at 12728 19Th Ave Se Ste 200 , Everett WA 98208-6526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Mahidhar, Ravilla L can be contacted via phone (425) 225-2700.Contact Information
Primary practice address
12728 19Th Ave Se Ste 200
Everett WA 98208-6526
Phone: (425) 225-2700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | D81014 | Maryland |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | MD450900 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | MD60287555 | Washington |
Profile Details
| NPI number | 1134346836 |
|---|---|
| LBN Legal business name | Mahidhar, Ravilla L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2007 |
| Last updated | Jul 7th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134346836 | NPPES |
| Washington | Other | G8910100 | MEDICARE |
| Washington | Other | AT540010 | MEDICARE |
| Washington | MEDICAID | 213409800 | MEDICARE |
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