Individual
DR. BALAVITTAL VARANASI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
936 M L KING DR, CENTRALIA, IL 62801-3058
(618) 532-6439
(618) 532-1549
Mailing address
936 M L KING DR, CENTRALIA, IL 62801-3058
(618) 532-6439
(618) 532-1549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-085451
IL
Other
Enumeration date
02/28/2006
Last updated
01/05/2015
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