Healthcare Provider Details

I. General information

NPI: 1881662658
Provider Name (Legal Business Name): MADHAVI KAVIPURAPU MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 05/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30680 BAINBRIDGE RD COMMUNTIY HOSPITALISTS
CLEVELAND OH
44139-2282
US

IV. Provider business mailing address

6400 CENTER STREET APT B104
MENTOR OH
44060
US

V. Phone/Fax

Practice location:
  • Phone: 440-542-5023
  • Fax:
Mailing address:
  • Phone: 440-749-0128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.087472
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: