Individual
MR. RAGHURAMAN R VIDHUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
455 CHASE PKWY, WATERBURY, CT 06708-3352
(203) 573-1435
(203) 755-7433
Mailing address
455 CHASE PKWY, WATERBURY, CT 06708-3352
(203) 573-1435
(203) 755-7433
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
045393
CT
207RC0000X
Cardiovascular Disease Physician
236091
NY
207RI0011X
Interventional Cardiology Physician
Primary
045393
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001453935
—
CT
01
—
010045393CT02
ANTHEM BCBS CT
CT
01
—
045393-7359
CONNECTICARE
CT
05
—
1578680062
—
CT
01
—
27-87690
UHC
CT
01
—
3V1106
HEALTHNET/COMMERCIAL
CT
01
—
407405
WELLCARE
CT
01
—
7946957
AETNA
CT
01
—
PENDING
RR MEDICARE
CT
Enumeration date
03/22/2007
Last updated
03/02/2015
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