Individual
DR. MADHUSUDAN N DHARAWAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3523 BLUELAKE CIR, STOCKTON, CA 95219-1745
(304) 215-2490
Mailing address
3523 BLUELAKE CIR, STOCKTON, CA 95219-1745
(304) 215-2490
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21010
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2003824000
—
WV
Enumeration date
02/12/2007
Last updated
06/21/2021
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