Provider Demographics
NPI:1528353687
Name:BIRADAVOLU, ARUN K (DO)
Entity type:Individual
Prefix:DR
First Name:ARUN
Middle Name:K
Last Name:BIRADAVOLU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5 JANNA CT
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6325
Mailing Address - Country:US
Mailing Address - Phone:845-659-1101
Mailing Address - Fax:845-625-2668
Practice Address - Street 1:5 JANNA CT
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-6325
Practice Address - Country:US
Practice Address - Phone:845-659-1101
Practice Address - Fax:845-625-2668
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 12933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine