Provider Demographics
NPI:1992005854
Name:TANGIRALA, BHARGAVI (MD)
Entity Type:Individual
Prefix:
First Name:BHARGAVI
Middle Name:
Last Name:TANGIRALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 THOMAS MORE PKWY STE 404
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-5102
Mailing Address - Country:US
Mailing Address - Phone:859-341-6281
Mailing Address - Fax:330-729-9297
Practice Address - Street 1:830 THOMAS MORE PKWY STE 202
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-5103
Practice Address - Country:US
Practice Address - Phone:859-341-6281
Practice Address - Fax:330-729-9297
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35121812207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology