Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036122096 | IL |
N | 111NI0900X | Internist | 036122096 | IL |
Y | 207RI0200X | Infectious Disease | 45624 | KY |
NPI | 1033235338 |
---|---|
Provider Name | Anupama Raghuram |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-1622 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 24/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100227690 | (05) | KY |