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General NPI Number Information
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NPI Number | 1013102821
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Entity Type | Organization
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Legal Business Name | RAGHU P. UPENDER, MD, NEUROHEALTH PC
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 09/14/2007
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Provider Practice Location Address
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Address Line | 1805 N JACKSON ST SUITE 7
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City | TULLAHOMA
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State | TN
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Zip | 37388-2290
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Country | US
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Telephone | 931-461-5946
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Fax | 931-461-5948
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Provider Business Mailing Address
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Address Line | 1805 N JACKSON ST SUITE 7
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City | TULLAHOMA
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State | TN
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Zip | 37388-2290
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Country | US
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Telephone | 931-461-5946
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Fax | 931-461-5948
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RAGHU PISHKA UPENDER
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Credential | MD
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Telephone | 931-461-5946
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 39248
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License Number State | TN
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