Vidhun, Raghuraman R
Vidhun, Raghuraman R is an individual health care provider with primary practice located at 455 Chase Pkwy , Waterbury CT 06708-3352. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Vidhun, Raghuraman R can be contacted via phone (203) 573-1435.Contact Information
Primary practice address
455 Chase Pkwy
Waterbury CT 06708-3352
Phone: (203) 573-1435
Fax: (203) 755-7433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 045393 | Connecticut |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 236091 | New York |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 045393 | Connecticut |
Profile Details
| NPI number | 1578680062 |
|---|---|
| LBN Legal business name | Vidhun, Raghuraman R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 22nd, 2007 |
| Last updated | Mar 2nd, 2015 - about 9 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 | 1578680062 | NPPES |
| Connecticut | Other | PENDING | RR MEDICARE |
| Connecticut | MEDICAID | 1578680062 | RR MEDICARE |
| Connecticut | Other | 27-87690 | RR MEDICARE |
| Connecticut | Other | 7946957 | RR MEDICARE |
| Connecticut | Other | 010045393CT02 | RR MEDICARE |
| Connecticut | Other | 3V1106 | RR MEDICARE |
| Connecticut | Other | 27-87690 | RR MEDICARE |
| Connecticut | MEDICAID | 001453935 | RR MEDICARE |
| Connecticut | Other | 045393-7359 | RR MEDICARE |
| Connecticut | Other | 407405 | RR MEDICARE |
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