Healthcare Provider Details

I. General information

NPI: 1518938521
Provider Name (Legal Business Name): ANIL PRAKASH TUMBAPURA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2006
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 ATLANTIC AVE
RALEIGH NC
27604-1502
US

IV. Provider business mailing address

2513 BELDEN PL
RALEIGH NC
27614-7405
US

V. Phone/Fax

Practice location:
  • Phone: 919-881-9999
  • Fax: 919-881-9998
Mailing address:
  • Phone: 919-413-7091
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number200200821
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: