Basic Information
| Provider Information | |||||||||
| NPI: | 1336484013 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAVINDRAN | ||||||||
| FirstName: | BHANU | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3723 53RD AVE | ||||||||
| Address2: | SPRINGS AT BETTENDORF | ||||||||
| City: | BETTENDORF | ||||||||
| State: | IA | ||||||||
| PostalCode: | 527221191 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5638238404 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2701, 17TH ST | ||||||||
| Address2: | TRINITY MEDICAL CENTRE | ||||||||
| City: | ROCK ISLAND | ||||||||
| State: | IL | ||||||||
| PostalCode: | 61201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3097795000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2012 | ||||||||
| LastUpdateDate: | 12/06/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036.131659 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.