Doctor Name: | RAVI MURALI |
NPI Number: | 1134310451 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | 55080 |
Business Practice Address: | 814 Lynn Ave Baraboo, WI - 539132745 |
Business Phone Number: | 6083565551 |
Business Fax Number: | 6083552238 |
Mailing Address: | 801 Lynn Ave, BARABOO |
State: | WI |
Postal Code: | 539132746 |
Phone Number: | 6083565551 |
Fax Number: | 6083552238 |
NPI Enumeration Date: | 08/05/2007 |
NPI Last Update Date: | 07/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 55080 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |