Individual
DR. HARSHA VINEETH POLAVARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
927 BROADWAY ST, SUITE 130, QUINCY, IL 62301-2719
(217) 224-6423
Mailing address
927 BROADWAY ST STE 302, QUINCY, IL 62301-2727
(217) 224-6423
(217) 214-5819
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036132336
IL
208600000X
Surgery Physician
2014044161
MO
208600000X
Surgery Physician
MT189997
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208600000X
SURGERY
IL
Enumeration date
06/10/2008
Last updated
11/27/2023
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