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General NPI Number Information
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NPI Number | 1427996404
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Entity Type | Organization
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Legal Business Name | NEW GI PC
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Dates
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Enumeration Date | 03/23/2026
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 1015 S HACKETT RD
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City | WATERLOO
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State | IA
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Zip | 50701-3543
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Country | US
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Telephone | 319-234-5990
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Fax | 319-234-5994
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Provider Business Mailing Address
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Address Line | 1015 S HACKETT RD
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City | WATERLOO
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State | IA
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Zip | 50701-3543
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Country | US
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Telephone | 319-234-5990
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Fax | 319-234-5994
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Authorized Official
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Title or Position | PRESIDENT
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Name | RAVINDRA MALLAVARAPU
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Credential | MD
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Telephone | 319-234-5990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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