Individual
BALA KOTESWARA RAO DAVULURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2354 WEST BOULVARD, KOKOMO, IN 46902-6069
(765) 457-4800
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
01084760A
IN
2084N0400X
Neurology Physician
52575
MN
2084N0400X
Neurology Physician
62281-020
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407010754
—
MN
Enumeration date
07/16/2008
Last updated
04/15/2022
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