Provider Demographics
NPI:1801588348
Name:MUTHAVARAPU, NEHA CHOUDARY (MD)
Entity type:Individual
Prefix:
First Name:NEHA
Middle Name:CHOUDARY
Last Name:MUTHAVARAPU
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 1:4370 SCARLET LOOP
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7377
Mailing Address - Country:US
Mailing Address - Phone:813-486-9617
Mailing Address - Fax:
Practice Address - Street 1:800 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-3255
Practice Address - Country:US
Practice Address - Phone:309-655-2274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125081981208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics