Provider Demographics
NPI:1104075035
Name:BELVADI, YASHASWI SRINIVASA MURTHY (MD)
Entity type:Individual
Prefix:
First Name:YASHASWI
Middle Name:SRINIVASA MURTHY
Last Name:BELVADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:YASHASWI
Other - Middle Name:
Other - Last Name:BELVADI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:211 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-1915
Mailing Address - Country:US
Mailing Address - Phone:618-234-2120
Mailing Address - Fax:618-641-5806
Practice Address - Street 1:211 S 3RD ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-1915
Practice Address - Country:US
Practice Address - Phone:618-234-2120
Practice Address - Fax:618-641-5806
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2025-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC187627207RC0200X
SC93688207RC0200X
ME017939208M00000X
IL036-138611207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist