Provider Demographics
NPI:1568642049
Name:NEELAKANTH R HARAPANAHALLI LLC
Entity Type:Organization
Organization Name:NEELAKANTH R HARAPANAHALLI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NEELAKANTH
Authorized Official - Middle Name:RAMACHANDRA
Authorized Official - Last Name:HARAPANAHALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-399-9966
Mailing Address - Street 1:602 S ATWOOD RD STE 207
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4396
Mailing Address - Country:US
Mailing Address - Phone:410-399-9966
Mailing Address - Fax:410-399-9995
Practice Address - Street 1:602 S ATWOOD RD STE 207
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4396
Practice Address - Country:US
Practice Address - Phone:410-399-9966
Practice Address - Fax:410-399-9995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF89590Medicare UPIN