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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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