Basic Information
| Provider Information | |||||||||
| NPI: | 1366658627 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RANAWAT | ||||||||
| FirstName: | NISHANT | ||||||||
| MiddleName: | SINGH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 4609 | ||||||||
| Address2: | |||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 975010184 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2163345859 | ||||||||
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| Practice Location | |||||||||
| Address1: | ASANTE ROGUE REGIONAL MEDICAL CENTER | ||||||||
| Address2: | 2825 E BARNETT ROAD | ||||||||
| City: | MEDFORD | ||||||||
| State: | OR | ||||||||
| PostalCode: | 97504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417897000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2007 | ||||||||
| LastUpdateDate: | 07/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084V0102X | MD192398 | OR | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 2085R0204X | MD192398 | OR | N | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2084N0400X | MD192398 | OR | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
No ID Information.