Provider Demographics
NPI:1356389803
Name:MAILAPUR, RAVINDRA V (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:RAVINDRA
Middle Name:V
Last Name:MAILAPUR
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:207 LONGWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5243
Mailing Address - Country:US
Mailing Address - Phone:256-265-1890
Mailing Address - Fax:256-265-1891
Practice Address - Street 1:207 LONGWOOD DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5243
Practice Address - Country:US
Practice Address - Phone:256-265-1890
Practice Address - Fax:256-265-1891
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26102208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51523902OtherBLUE CROSS BLUE SHIELD
AL051523902Medicaid
ALH66524Medicare UPIN
AL051537698MAIMedicare PIN