Individual
NAGABHUSHANAM R BOLLAVARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1401 HARRODSBURG RD STE A300, LEXINGTON, KY 40504-3787
(859) 313-4744
(859) 276-5939
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7840
(606) 330-7825
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
45813
KY
Other
Enumeration date
07/05/2010
Last updated
05/06/2019
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