Provider Demographics
NPI:1912375916
Name:GHIMIRE, RAGHUNANDAN
Entity Type:Individual
Prefix:
First Name:RAGHUNANDAN
Middle Name:
Last Name:GHIMIRE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 NORTH ST
Mailing Address - Street 2:DEPATMENT OF MEDICINE
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4109
Mailing Address - Country:US
Mailing Address - Phone:413-447-2839
Mailing Address - Fax:413-447-2088
Practice Address - Street 1:725 NORTH ST
Practice Address - Street 2:DEPATMENT OF MEDICINE
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4109
Practice Address - Country:US
Practice Address - Phone:413-447-2839
Practice Address - Fax:413-447-2088
Is Sole Proprietor?:No
Enumeration Date:2015-09-08
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA264680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine