Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MT222148 | PA |
NPI | 1750763926 |
---|---|
Provider Name | Raghav Badrinath |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2015 |
Last Update Date | 12/07/2021 |