Healthcare Provider Details

I. General information

NPI: 1487746566
Provider Name (Legal Business Name): RAGHAVA V CHARYA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 08/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WALTER REED NATIONAL NAVAL CTR 8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

IV. Provider business mailing address

WALTER REED NATIONAL NAVAL CTR 8901 WISCONSIN AVE
BETHESDA MD
20889-0001
US

V. Phone/Fax

Practice location:
  • Phone: 202-782-6887
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberD41285
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: