Provider Demographics
NPI:1548465735
Name:SMITHFIELD FAMILY PRACTICE PA
Entity type:Organization
Organization Name:SMITHFIELD FAMILY PRACTICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER&DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RAGHU
Authorized Official - Middle Name:R
Authorized Official - Last Name:KATURU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-934-8977
Mailing Address - Street 1:1551 E BOOKER DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-9472
Mailing Address - Country:US
Mailing Address - Phone:919-934-8977
Mailing Address - Fax:919-938-3108
Practice Address - Street 1:1551 E BOOKER DAIRY RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-9472
Practice Address - Country:US
Practice Address - Phone:919-934-8977
Practice Address - Fax:919-938-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2014-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200401238207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1316970908OtherNPI NUMBER