MEDICARE: TALKAD S RAGHUVEER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080N0001X	Neonatal-Perinatal Medicine Physician	04-29244	KS
2	208000000X	Pediatrics Physician	04-29244	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	370018934	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	411310	OTHER		FIRSTGUARD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	29297014	OTHER	MO	BCBS KANSAS CITY

General Provider Information

NPI Number	:	1912017278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TALKAD S RAGHUVEER MD

Provider Business Mailing Address
First Line	:	3901 RAINBOW BLVD
Second Line	:	4070 DELP MAIL STOP 4017
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-7816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5354 MISSION WOODS RD
Second Line	:
City	:	MISSION WOODS
State	:	KS
Zip	:	66205-2008
Country	:	US
Telephone Number	:	913-269-9415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/18/2022

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Directions to “ TALKAD S RAGHUVEER MD” Practice Location

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