Individual
BAVIKATTE N SHIVAKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5041 UTICA RIDGE RD, SUITE 100, DAVENPORT, IA 52807-3480
(563) 359-9696
(563) 359-1730
Mailing address
5041 UTICA RIDGE RD, SUITE 100, DAVENPORT, IA 52807-3480
(563) 359-9696
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036063062
IL
174400000X
Specialist
22168
IA
207RG0100X
Gastroenterology Physician
Primary
036063062
IL
Other
Enumeration date
10/24/2005
Last updated
04/25/2016
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