MEDICARE: DILLI RAJ BHURTEL 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	2080P0202X	Pediatric Cardiology Physician	MD-44186	IA

General Provider Information

NPI Number	:	1952721409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DILLI RAJ BHURTEL MD

Provider Business Mailing Address
First Line	:	855 A AVE NE STE 310
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-5064
Country	:	US
Telephone Number	:	319-558-4951
Fax Number	:	319-558-4592

Provider Business Practice Location Address
First Line	:	855 A AVE NE STE 310
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-5064
Country	:	US
Telephone Number	:	319-558-4951
Fax Number	:	319-558-4592

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

Provider Enumeration Date	:	04/23/2014
Last Update Date	:	07/21/2022

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