Provider Demographics
NPI:1043265234
Name:RAVAL, YAGNESH RAMESHWAR (MD)
Entity type:Individual
Prefix:MR
First Name:YAGNESH
Middle Name:RAMESHWAR
Last Name:RAVAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2952 SHAWNEE TRAIL
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-9709
Mailing Address - Country:US
Mailing Address - Phone:937-773-2482
Mailing Address - Fax:937-440-4381
Practice Address - Street 1:3130 NORTH DIXIE HIGHWAY
Practice Address - Street 2:IMAGING DEPARTMENT
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-1309
Practice Address - Country:US
Practice Address - Phone:937-440-4800
Practice Address - Fax:937-440-4381
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-24
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350393602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0329120Medicaid
300029983OtherMEDICARE RAILROAD
OHA83113Medicare UPIN
OH0329120Medicaid
A83113Medicare UPIN