Organization
C.P. VASUDEVAN,M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CUDDALORE P VASUDEVAN M.D. (PRESIDENT)
(276) 322-5864
Entity
Organization
Contact information
Practice address
2117 COLLEGE AVE, BLUEFIELD, VA 24605-2002
(276) 322-5864
Mailing address
2117 COLLEGE AVE, BLUEFIELD, VA 24605-2002
(276) 322-5864
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001995560
MOUNTAIN STATE BC
—
05
—
1821288804
—
VA
01
—
290006991
RAILROAD MEDICARE
WV
01
—
308652
SOUTHEAST SERVICES
VA
05
—
3810010120
—
WV
01
—
4353209
AETNA
—
01
—
612758800
DEPARTMENT OF LABOR
—
01
—
P00450347
RAIL ROAD MEDICARE
VA
Enumeration date
07/26/2007
Last updated
03/31/2008
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