Healthcare Provider Details

I. General information

NPI: 1245962133
Provider Name (Legal Business Name): RAVI SANKAR VIJAY KARHIK BULUSU MBBS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2022
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-9979
  • Fax: 319-535-8073
Mailing address:
  • Phone: 319-384-9979
  • Fax: 319-535-8073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD-55200
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD-55200
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: