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Organization
NEW GI PC
Active
Organization
NEW GI PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVINDRA MALLAVARAPU MD (PRESIDENT)
(319) 234-5990
Entity
Organization
Contact information
Practice address
1015 S HACKETT RD, WATERLOO, IA 50701-3543
(319) 234-5990
(319) 234-5994
Mailing address
1015 S HACKETT RD, WATERLOO, IA 50701-3543
(319) 234-5990
(319) 234-5994
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
03/23/2026
Last updated
03/23/2026
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