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NPI Code Detail

MEDICARE: DELSIE BELLA GAVALI MD

MEDICARE: DELSIE BELLA GAVALI MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianIL

General Provider Information

NPI Number : 1063504744
Entity Type Code : Individual
Provider Name (Legal Business Name) : DELSIE BELLA GAVALI MD
Provider Business Mailing Address
First Line : 526 W STATE STREET
Second Line :
City : ROCKFORD
State : IL
Zip : 61101-1214
Country : US
Telephone Number : 815-968-9300
Fax Number : 815-968-5314
Provider Business Practice Location Address
First Line : 526 W STATE STREET
Second Line :
City : ROCKFORD
State : IL
Zip : 61101-1214
Country : US
Telephone Number : 815-968-9300
Fax Number : 815-968-5314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 07/08/2007

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Directions to “ DELSIE BELLA GAVALI MD” Practice Location

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