Davuluri, Bala Koteswara Rao

Davuluri, Bala Koteswara Rao is an individual health care provider with primary practice located at 2354 West Boulvard , Kokomo IN 46902-6069. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Davuluri, Bala Koteswara Rao can be contacted via phone (765) 457-4800.

Contact Information

Primary practice address
2354 West Boulvard Kokomo IN 46902-6069
Phone: (765) 457-4800
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 52575 Minnesota
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 62281-020 Wisconsin
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 01084760A Indiana

Profile Details

NPI number 1407010754
LBN Legal business name Davuluri, Bala Koteswara Rao
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2008
Last updated Apr 15th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407010754 NPPES
Minnesota MEDICAID 1407010754

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