Physician Compare National (NPI:1326237322)

HEALTHCARE PROVIDER: CHIDAMBARAM RAGHAVAN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1326237322
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0648349043
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080527000075
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RAGHAVAN
	Individual professional last name
Provider First Name	CHIDAMBARAM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5077 DALLAS HWY 315
	Group Practice or individual's line 1 address
City	POWDER SPRINGS
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	301274510
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	110035
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WELLSTAR KENNESTONE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	110042
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WELLSTAR PAULDING HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	110143
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WELLSTAR COBB HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y