MEDICARE: MRS. BHAVANI LAGADAPATI 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	207R00000X	Internal Medicine Physician	2007-01007	NC
2	207R00000X	Internal Medicine Physician	38359	KY

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	:	1760484299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BHAVANI LAGADAPATI MD

Provider Business Mailing Address
First Line	:	2501 ATRIUM DR
Second Line	:	SUITE 305
City	:	RALEIGH
State	:	NC
Zip	:	27607-6452
Country	:	US
Telephone Number	:	919-297-0348
Fax Number	:	919-297-0349

Provider Business Practice Location Address
First Line	:	101 LATTNER CT
Second Line	:	SUITE 100
City	:	MORRISVILLE
State	:	NC
Zip	:	27560-6843
Country	:	US
Telephone Number	:	919-297-0348
Fax Number	:	919-297-0349

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

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	02/05/2015

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