MEDICARE: HEMANTH ADHAR BABOOLAL MD

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	207L00000X	Anesthesiology Physician	188030	NC

General Provider Information

NPI Number	:	1730178070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEMANTH ADHAR BABOOLAL MD

Provider Business Mailing Address
First Line	:	PO BOX 271647
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84127-1647
Country	:	US
Telephone Number	:	919-966-5136
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEPARTMENT OF ANESTHESIOLOGY
Second Line	:	N2198 UNC HOSPITALS CB# 7010
City	:	CHAPEL HILL
State	:	NC
Zip	:	27599-7010
Country	:	US
Telephone Number	:	919-966-5136
Fax Number	:

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	09/23/2016

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