Organization
WEST COBB INTERNAL MEDICINE PC
Active
Other names
Chidambaram Raghavan MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHIDAMBARAM RAGHAVAN MD (MEDICAL DIRECTOR)
(770) 218-1880
Entity
Organization
Contact information
Practice address
5041 DALLAS HWY, BLDG 2 SUITE E WEST COBB INTERNAL MEDICINE PC, POWDER SPRINGS, GA 30127
(770) 218-1880
(770) 218-1088
Mailing address
5041 DALLAS HIGHWAY, BLDG 2 SUITE E WEST COBB INTERNAL MEDICINE PC, POWDER SPRINGS, GA 30127
(770) 218-1880
(770) 218-1088
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38709
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00626117A
—
GA
01
—
0400005
UNITED HEALTHCARE
GA
01
—
4562104
AETNA
GA
01
—
617437
BCBS
GA
Enumeration date
11/15/2006
Last updated
04/20/2008
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