MEDICARE: DR. BHAVANI BALARAVI 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
1	207RC0000X	Cardiovascular Disease Physician	44906	MN
2	207RC0000X	Cardiovascular Disease Physician	2008-01670	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	20223417	OTHER	NC	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982681417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAVANI BALARAVI MD

Provider Business Mailing Address
First Line	:	300 ASHVILLE AVE
Second Line	:	SUITE 301
City	:	CARY
State	:	NC
Zip	:	27518-8682
Country	:	US
Telephone Number	:	919-851-6901
Fax Number	:	919-851-9354

Provider Business Practice Location Address
First Line	:	300 ASHVILLE AVE
Second Line	:	SUITE 301
City	:	CARY
State	:	NC
Zip	:	27518-8682
Country	:	US
Telephone Number	:	919-851-6901
Fax Number	:	919-851-9354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	01/17/2011

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Directions to “ DR. BHAVANI BALARAVI MD” Practice Location

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