Provider Demographics
NPI:1790729523
Name:HARAPANAHALLI, NEELAKANTH RAMACHANDRA (MD)
Entity Type:Individual
Prefix:
First Name:NEELAKANTH
Middle Name:RAMACHANDRA
Last Name:HARAPANAHALLI
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 1:602 S ATWOOD RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014
Mailing Address - Country:US
Mailing Address - Phone:410-399-9966
Mailing Address - Fax:410-399-9995
Practice Address - Street 1:602 S ATWOOD RD
Practice Address - Street 2:STE 207
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014
Practice Address - Country:US
Practice Address - Phone:410-399-9966
Practice Address - Fax:410-399-9995
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0045680207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD208681600Medicaid
MD208681600Medicaid
F89590Medicare UPIN