MEDICARE: ANIL PRAKASH TUMBAPURA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	200200821	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518938521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANIL PRAKASH TUMBAPURA M.D.

Provider Business Mailing Address
First Line	:	2513 BELDEN PL
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27614-7405
Country	:	US
Telephone Number	:	919-413-7091
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 ATLANTIC AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27604-1502
Country	:	US
Telephone Number	:	919-881-9999
Fax Number	:	919-881-9998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2006
Last Update Date	:	04/22/2021

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