Gudibanda, Raghunath

Gudibanda, Raghunath is an individual health care provider with primary practice located at 315 E Broadway Ste 185E , Louisville KY 40202-3700. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Gudibanda, Raghunath can be contacted via phone (502) 629-5455.

Contact Information

Primary practice address
315 E Broadway Ste 185E Louisville KY 40202-3700
Phone: (502) 629-5455
Fax: (502) 629-4151
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 41448 Kentucky
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 41448 Kentucky

Profile Details

NPI number 1659418119
LBN Legal business name Gudibanda, Raghunath
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Sep 10th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659418119 NPPES
Kentucky Other 50021428 PASSPORT
Kentucky Other 3552164000 PASSPORT
Kentucky Other 000023033X PASSPORT
Kentucky Other 000000587053 PASSPORT
Kentucky Other 098231 PASSPORT
Kentucky MEDICAID 200948520 PASSPORT
Kentucky MEDICAID 7100064020 PASSPORT

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