Healthcare Provider Details

I. General information

NPI: 1639332745
Provider Name (Legal Business Name): BHAVYA AKHAURI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

788 8TH AVENUE SE LEVEL 3
CEDAR RAPIDS IA
52401
US

IV. Provider business mailing address

788 8TH AVENUE SE LEVEL 3
CEDAR RAPIDS IA
52401
US

V. Phone/Fax

Practice location:
  • Phone: 319-369-4542
  • Fax: 319-369-4543
Mailing address:
  • Phone: 319-369-4542
  • Fax: 319-369-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD-41841
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: