Individual
DR. RAGHURAM S MODUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 BYPASS RD, LEONARD LAWSON CANCER CENTER, PIKEVILLE, KY 41501
(606) 437-3516
(606) 218-4912
Mailing address
PO BOX 2652, PIKEVILLE, KY 41502
(606) 437-3516
(606) 218-4912
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
20702
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048402
ANTHEM BC KY
—
05
—
64207020
—
KY
Enumeration date
09/08/2005
Last updated
07/30/2014
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