Provider Demographics
NPI:1689038291
Name:BATLAWALA, DAVIT ANILKUMAR (MD)
Entity Type:Individual
Prefix:
First Name:DAVIT
Middle Name:ANILKUMAR
Last Name:BATLAWALA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 OLD MONTGOMERY HWY APT 2232
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-5052
Mailing Address - Country:US
Mailing Address - Phone:248-722-1540
Mailing Address - Fax:
Practice Address - Street 1:45 E RIVER PARK PL W STE 507
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-1565
Practice Address - Country:US
Practice Address - Phone:559-603-7367
Practice Address - Fax:559-603-7366
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-09
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD38593207R00000X
CAA173457207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine