Individual
RAVI KUMAR RAJU GADIRAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-5416
(704) 384-5992
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5416
(704) 384-5992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01062363A
IN
207R00000X
Internal Medicine Physician
2007-01018
NC
208M00000X
Hospitalist Physician
Primary
2007-01018
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200840670
—
IN
05
—
5907666
—
NC
05
—
N0101D
—
SC
Enumeration date
07/16/2006
Last updated
06/14/2023
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