Individual
SHUBHA VANESSA YVONNE RAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.B.B.S., M.H.S.
Contact information
Practice address
925 UNION ST STE 2, BANGOR, ME 04401-3051
(207) 973-5918
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
018617
ME
207L00000X
Anesthesiology Physician
241943
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
018617
ME
207LP2900X
Pain Medicine (Anesthesiology) Physician
241943
MA
Other
Enumeration date
02/27/2007
Last updated
04/06/2020
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