Healthcare Provider Details

I. General information

NPI: 1437394418
Provider Name (Legal Business Name): RAGHAVENDER GOTUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 FALLS OF NEUSE RD
RALEIGH NC
27614-7838
US

IV. Provider business mailing address

1140 HOLLY SPRINGS RD STE 108
HOLLY SPRINGS NC
27540-9634
US

V. Phone/Fax

Practice location:
  • Phone: 919-350-8000
  • Fax:
Mailing address:
  • Phone: 919-322-9865
  • Fax: 919-322-9865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01068909A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2015-02304
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01068909A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: