Organization
WEST COBB INTERNAL MEDICINE PC
Active
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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