| Doctor Name: | DR. RAGHU DHARMAVARAM KOTTAM |
| NPI Number: | 1265606321 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D |
| License Number: | C1-0009710 |
| Business Practice Address: | 113 Neurology Way Milford, DE - 199635368 |
| Business Phone Number: | 3023935006 |
| Business Fax Number: | 3024223074 |
| Mailing Address: | 640 S State St, 742 Bldg DOVER |
| State: | DE |
| Postal Code: | 199013530 |
| Phone Number: | 3026743970 |
| Fax Number: | 3026722350 |
| NPI Enumeration Date: | 04/18/2008 |
| NPI Last Update Date: | 10/12/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | C1-0009710 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |