Provider Demographics
NPI:1790014595
Name:BELUR, ANURADHA AVINASH (MD)
Entity Type:Individual
Prefix:
First Name:ANURADHA
Middle Name:AVINASH
Last Name:BELUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANURADHA
Other - Middle Name:SHANKAR
Other - Last Name:RAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:121 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-4931
Mailing Address - Country:US
Mailing Address - Phone:253-876-8200
Mailing Address - Fax:
Practice Address - Street 1:121 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4931
Practice Address - Country:US
Practice Address - Phone:253-876-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2015-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60530777207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology