Individual
RAGHURAM DASARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 E US HIGHWAY 6 STE 300, VALPARAISO, IN 46383-8948
(219) 983-6300
(219) 983-6080
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(216) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01060158A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000496942
BLUE CROSS BLUE SHIELD IN
—
05
—
200506520
—
IN
01
—
90000561
BLUE SHIELD OF IL
—
01
—
P00369368
RAILROAD MEDICARE
—
Enumeration date
11/18/2005
Last updated
09/14/2020
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