MEDA RAGHAVENDRA MD NPI 1629048962

NPI Information

Meda Raghavendra, MD is an interventional pain medicine pain medicine in Maywood, IL. The provider is interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. Meda Raghavendra, MD NPI is 1629048962. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2160 S FIRST AVE
(15750 MARIAN DR., HOMER GLEN, IL. 60526)
MAYWOOD, IL
ZIP 60153
Phone: (708) 216-6462
Fax: (708) 216-1249

The NPI 1629048962 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/26/2006 and was last updated on 3/4/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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