Healthcare Provider Details

I. General information

NPI: 1982283388
Provider Name (Legal Business Name): BHAVANA MAKKAPATI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 10TH ST SE
CEDAR RAPIDS IA
52403-1251
US

IV. Provider business mailing address

2878 ASH CT
CORALVILLE IA
52241-4712
US

V. Phone/Fax

Practice location:
  • Phone: 319-519-3044
  • Fax:
Mailing address:
  • Phone: 319-519-3044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD-56685
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: