Ravella, Pavan Mahendra

Ravella, Pavan Mahendra is an sole proprietor health care provider with primary practice located at 420 N 26Th St , Lafayette IN 47904-2848. He recently has 3 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Medical Oncology. Allopathic & Osteopathic Physicians / Hematology is his primary health care specialty. Ravella, Pavan Mahendra can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
420 N 26Th St Lafayette IN 47904-2848
Phone: (765) 448-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Hematology 207RH0000X 01075948A Indiana
Allopathic & Osteopathic Physicians / Medical Oncology 207RX0202X 01075948A Indiana

Profile Details

NPI number 1710212147
LBN Legal business name Ravella, Pavan Mahendra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 2nd, 2009
Last updated Mar 15th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710212147 NPPES
Indiana MEDICAID 201320510
Indiana Other 000000964118

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