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RAGHAVENDRA B RAO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
516 DELAWARE ST SE, PWB FOURTH FLOOR, ROOM 4-100, MINNEAPOLIS, MN 55455-0356
(612) 626-0644
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(612) 626-0644

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
40598
MN
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
40598
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0052338
MT
05
017323100
MN
01
1017141
PREFERRED ONE
MN
01
10R74RA
BLUE CROSS BLUE SHIELD
MN
01
122838
UCARE
MN
01
17-07037
MEDICA PRIMARY
MN
01
4707037
MEDICA CHOICE
MN
01
795517
ARAZ
MN
01
HP28863
HEALTH PARTNERS
MN
Enumeration date
10/23/2006
Last updated
10/26/2012
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