Provider Demographics
NPI:1356459473
Name:ABC NEUROLOGY, P.L.L.C.
Entity Type:Organization
Organization Name:ABC NEUROLOGY, P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BAPU
Authorized Official - Middle Name:CHAND
Authorized Official - Last Name:ALURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:928-314-3702
Mailing Address - Street 1:1230 W 24TH ST
Mailing Address - Street 2:STE.1
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-6232
Mailing Address - Country:US
Mailing Address - Phone:928-314-3702
Mailing Address - Fax:928-314-4687
Practice Address - Street 1:1230 W 24TH ST
Practice Address - Street 2:STE.1
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-6232
Practice Address - Country:US
Practice Address - Phone:928-314-3702
Practice Address - Fax:928-314-4687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ286842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ551095Medicaid
AZ793647Medicaid
AZAZ0880500OtherBC/BS OF AZ.
AZZ75491Medicare ID - Type UnspecifiedBAPU ALURI, M.D.
AZ793647Medicaid
AZH28463Medicare UPIN
AZP92498Medicare UPIN
AZZ75490Medicare ID - Type UnspecifiedABC NEUROLOGY, P.L.L.C.