Provider Demographics
NPI:1669432183
Name:POLAVARAPU, NAVEENA
Entity type:Individual
Prefix:DR
First Name:NAVEENA
Middle Name:
Last Name:POLAVARAPU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NAVEENA
Other - Middle Name:
Other - Last Name:POLAVARAPU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3305 SUNGATE BLVD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-2871
Mailing Address - Country:US
Mailing Address - Phone:919-212-0129
Mailing Address - Fax:919-255-1540
Practice Address - Street 1:3305 SUNGATE BLVD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-212-0129
Practice Address - Fax:919-255-1540
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI45092207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine