Individual
DR. NARASIMHA RAO BOORGU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
422 E DR HICKS BLVD, FLORENCE, AL 35630-5763
(256) 766-1401
(256) 766-1402
Mailing address
422 E DR HICKS BLVD, FLORENCE, AL 35630-5763
(256) 766-1401
(256) 766-1402
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
000008018
AL
207RN0300X
Nephrology Physician
Primary
000008018
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000582
—
AL
01
—
110126478
MEDICARE RAILROAD/PALMETTO GBA - INDIVIDUAL
SC
05
—
529400760
—
AL
01
—
CC6102
MEDICARE RAILROAD/PALMETTO GBA GROUP
SC
Enumeration date
07/13/2005
Last updated
10/21/2008
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