| Ravina V Kadam, MD | |
|
300 Medical Dr Ste 704, Lagrange, GA 30240-4130 | |
| (706) 880-7361 | |
| Not Available |
| Full Name | Ravina V Kadam |
|---|---|
| Gender | Female |
| Speciality | Internal Medicine |
| Experience | 26 Years |
| Location | 300 Medical Dr Ste 704, Lagrange, Georgia |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134183742 | NPI | - | NPPES |
| 202193 | Other | MO | BLUE SHIELD/BLUE CHOICE |
| 732685 | Other | MO | HEALTHLINK |
| P00310560 | Other | MO | RR MEDICARE |
| 200455004 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 28388 (Alabama) | Secondary |
| 207R00000X | Internal Medicine | 2005037959 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | 62902 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Georgia Home Health | Columbus, GA | Home health agency |
| Wellstar West Georgia Medical Center | Lagrange, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Wellstar Medical Group Llc | 6709065402 | 2734 |
| Chronic Disease Management Of Georgia Llc | 7618306721 | 72 |
| Entity Name | Wellstar Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
| Entity Name | Chronic Disease Management Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1699300939 PECOS PAC ID: 7618306721 Enrollment ID: O20200409003695 |
| Mailing Address | Practice Location Address |
|---|---|
| Ravina V Kadam, MD 303 Medical Drive, Ste 406, Lagrange, GA 30240-4145 Ph: (706) 880-7361 | Ravina V Kadam, MD 300 Medical Dr Ste 704, Lagrange, GA 30240-4130 Ph: (706) 880-7361 |
Steven Tae Yi, DO Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1514 Vernon Rd, Lagrange, GA 30240 Phone: 706-882-1411 | |
Juan Francisco Vasquez Mendez, MD Internal Medicine Medicare: May Accept Medicare Assignments Practice Location: 106 Old Mill Rd Ste 100, Lagrange, GA 30241 Phone: 706-803-8500 | |
Kenneth T Horlander, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: Clark-holder Clinic, P.a., 303 Smith Street, Lagrange, GA 30240 Phone: 706-882-8831 Fax: 706-812-4091 | |
Syed Abuzar Waseem Ahmed, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1602 Vernon Rd Ste 400, Lagrange, GA 30240 Phone: 706-882-9341 Fax: 706-884-0131 | |
Mr. Melhim Bou Alwan, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1514 Vernon Rd, Lagrange, GA 30240 Phone: 706-882-1411 Fax: 706-812-2471 | |
Dr. Ariyo Oluwole Olobatoke, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1551 Doctors Dr, Lagrange, GA 30240 Phone: 706-880-7222 Fax: 706-880-7223 |