Provider Demographics
NPI:1649417999
Name:TIRUPATHI GOVINDARAJU, RAGHAVENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAGHAVENDRA
Middle Name:
Last Name:TIRUPATHI GOVINDARAJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:RAGHAVENDRA
Other - Middle Name:
Other - Last Name:GOVINDARAJU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:22 ST PAUL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-1033
Mailing Address - Country:US
Mailing Address - Phone:717-709-7922
Mailing Address - Fax:717-263-2055
Practice Address - Street 1:830 5TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-4224
Practice Address - Country:US
Practice Address - Phone:717-709-7970
Practice Address - Fax:717-709-7971
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD444858207R00000X
NJ25MA08643800207R00000X
PAMD-444858207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine