MEDICARE: DR. BHAKTAVATSALA RAO APURI M.D., FACC

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	207RC0000X	Cardiovascular Disease Physician	01054665A	IN

General Provider Information

NPI Number	:	1902960966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAKTAVATSALA RAO APURI M.D., FACC

Provider Business Mailing Address
First Line	:	6920 POINTE INVERNESS WAY STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7934
Country	:	US
Telephone Number	:	260-479-3514
Fax Number	:	260-479-3520

Provider Business Practice Location Address
First Line	:	800 BROADWAY STE 200
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-2149
Country	:	US
Telephone Number	:	260-458-3410
Fax Number	:	260-458-3411

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	07/30/2024

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