Provider Demographics
NPI:1164464590
Name:NARRA, MADHU BABU (MD, MS)
Entity Type:Individual
Prefix:DR
First Name:MADHU
Middle Name:BABU
Last Name:NARRA
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2851 S AVENUE B STE 2001
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7763
Mailing Address - Country:US
Mailing Address - Phone:928-336-2434
Mailing Address - Fax:928-336-2435
Practice Address - Street 1:2851 S AVENUE B STE 2001
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7763
Practice Address - Country:US
Practice Address - Phone:928-336-2434
Practice Address - Fax:928-336-2435
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5277207K00000X, 207RA0201X, 207KA0200X
AZ52456207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX343795YQ3YOtherMEDICARE PTAN
TXTXB104362Medicare PIN