Individual
DR. SRINIVASA RAGHAVAN MADHAVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
801 BROADWAY N, FARGO, ND 58102-3641
(701) 234-5933
Mailing address
PO BOX 2168, FARGO, ND 58107-2168
(701) 234-2119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13694
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
ND
Other
Enumeration date
07/31/2012
Last updated
06/20/2023
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