Provider Demographics
NPI:1508421272
Name:RAGHUBIR, JAVITA (PA-C)
Entity type:Individual
Prefix:
First Name:JAVITA
Middle Name:
Last Name:RAGHUBIR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 OAK CT STE 100
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45430-1064
Mailing Address - Country:US
Mailing Address - Phone:937-404-1101
Mailing Address - Fax:937-404-1210
Practice Address - Street 1:8459 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-3938
Practice Address - Country:US
Practice Address - Phone:513-815-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1003436A363A00000X
OH50.009247RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant