Provider Demographics
NPI:1770638173
Name:BOYAPATI, SHALINI (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALINI
Middle Name:
Last Name:BOYAPATI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:DEPT. OF CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:FORT WORTH VA CLINIC
Practice Address - Street 2:2201 SOUTHEAST LOOP 820
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76119
Practice Address - Country:US
Practice Address - Phone:817-730-0000
Practice Address - Fax:817-730-0601
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT1021207R00000X
MDP18627207R00000X
MDD65616207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS589Q713Medicare PIN