Provider Demographics
NPI:1104558154
Name:RAVI, SOUMIYA
Entity type:Individual
Prefix:
First Name:SOUMIYA
Middle Name:
Last Name:RAVI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CHRISTIANA CARE HEALTH SERVICES
Mailing Address - Street 2:4755 OGLETOWN-STANTON ROAD, E TOWER, ROOM-2875
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19718
Mailing Address - Country:US
Mailing Address - Phone:302-733-1882
Mailing Address - Fax:302-733-1103
Practice Address - Street 1:CHRISTIANA CARE HEALTH SERVICES
Practice Address - Street 2:4755 OGLETOWN-STANTON ROAD, E TOWER, ROOM-2875
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19718
Practice Address - Country:US
Practice Address - Phone:302-733-1882
Practice Address - Fax:302-733-1103
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0018930207RC0000X
AZR79327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine