Most Relevant Information
Provider Data
| NPI Number: | 1003198938 |
| Provider Name: | RAVISHANKAR SHIVASHANKAR MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/16/2011 |
| Last Updated: | 02/07/2014 |
Provider Practice Location
22 S GREENE ST # G2K14
BALTIMORE
MD
212011544
Practice Location Phone/Fax
| Phone: | 4103285112 |
| Fax: | 4103283168 |
Provider Mailing Location
22 S GREENE ST # G2K14
BALTIMORE
MD
212011544
Provider Mailing Phone/Fax
| Phone: | 4103285112 |
| Fax: | 4103283168 |