Organization
RIVERSIDE PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAMCHANDER RAO MADHAVARAPU M.D. (OWNER)
(503) 325-7337
Entity
Organization
Contact information
Practice address
2120 EXCHANGE ST, SUITE 202, ASTORIA, OR 97103-3365
(503) 325-7337
(503) 325-3706
Mailing address
2120 EXCHANGE ST, SUITE 202, ASTORIA, OR 97103-3365
(503) 325-7337
(503) 325-3706
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD25214
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1119858
—
WA
05
—
276048
—
OR
Enumeration date
04/02/2007
Last updated
07/16/2007
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