Individual
DR. RAGHUNANDAN KAMINENI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
665 WINTER ST SE, SUITE B0350, SALEM, OR 97301-3934
(503) 814-4440
(503) 561-7180
Mailing address
PO BOX 886, SALEM, OR 97308-0886
(503) 814-4440
(503) 561-7180
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
MD25541
OR
207RI0011X
Interventional Cardiology Physician
MD
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269541
—
OR
01
—
R152646
MEDICARE PTAN
—
Enumeration date
08/02/2005
Last updated
07/21/2022
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