Provider Demographics
NPI:1447207691
Name:BHIMAVARAPU, ANURADHA M (MD)
Entity Type:Individual
Prefix:
First Name:ANURADHA
Middle Name:M
Last Name:BHIMAVARAPU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4015
Mailing Address - Country:US
Mailing Address - Phone:781-986-7800
Mailing Address - Fax:508-894-0412
Practice Address - Street 1:25 WARREN ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4015
Practice Address - Country:US
Practice Address - Phone:781-986-7900
Practice Address - Fax:508-894-0412
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA155695208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics