Provider Demographics
NPI:1013030022
Name:BELLAPRAVALU, SAMEER (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMEER
Middle Name:
Last Name:BELLAPRAVALU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3000 STAUNTON AVE SE
Mailing Address - Street 2:UNIT # 11
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1145
Mailing Address - Country:US
Mailing Address - Phone:304-388-5435
Mailing Address - Fax:
Practice Address - Street 1:1 HOSPITAL DRIVE ROOM 313
Practice Address - Street 2:PSYCHIATRY DEPT DC067.00
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-884-6136
Practice Address - Fax:573-884-1070
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010006687207R00000X, 2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine