Raghuram S Modur, MD

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

20702 Issued in KY

Practice address

911 Bypass Rd
Leonard Lawson Cancer Center
Pikeville, KY 41501

Phone

(606) 437-3516

Fax

(606) 218-4912

NPI assigned

Sep 8, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1528052214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2652",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "41502",
            "telephone_number": "606-437-3516",
            "fax_number": "606-218-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD",
            "address_2": "LEONARD LAWSON CANCER CENTER",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "41501",
            "telephone_number": "606-437-3516",
            "fax_number": "606-218-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODUR",
        "first_name": "RAGHURAM",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "KY",
            "license": "20702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC KY",
            "identifier": "000000048402",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64207020",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Michelle Miller, BA
• Tara Mink
• Tariq Mirza, M.D.
• Kevin Mischel, DMD
• MJR Anesthesia LLC
• Mollie Music & Associates
• Teanna J Moore, D.O.
• Terri Moore, BA
• Melissa A. Morey, PA-C
• Thomas Kevin Morey, P.A

• Radiation Oncology Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Radiation Oncology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.