Provider Demographics
NPI:1073772943
Name:DARUVURI, BHAVANA (DO)
Entity Type:Individual
Prefix:
First Name:BHAVANA
Middle Name:
Last Name:DARUVURI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 AMENIA RD
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:CT
Mailing Address - Zip Code:06069-2268
Mailing Address - Country:US
Mailing Address - Phone:860-364-0536
Mailing Address - Fax:
Practice Address - Street 1:50 AMENIA RD
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:CT
Practice Address - Zip Code:06069-2268
Practice Address - Country:US
Practice Address - Phone:860-364-0536
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT054373207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology