Provider Demographics
NPI:1912017278
Name:RAGHUVEER, TALKAD S (MD)
Entity Type:Individual
Prefix:
First Name:TALKAD
Middle Name:S
Last Name:RAGHUVEER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:4070 DELP MAIL STOP 4017
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-7816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5354 MISSION WOODS RD
Practice Address - Street 2:
Practice Address - City:MISSION WOODS
Practice Address - State:KS
Practice Address - Zip Code:66205-2008
Practice Address - Country:US
Practice Address - Phone:913-269-9415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-292442080N0001X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100396960AMedicaid
370018934OtherRR MEDICARE
411310OtherFIRSTGUARD
MO205364706Medicaid
MO29297014OtherBCBS KANSAS CITY